Ellis, Kim Marie

Ellis, Kim Marie is an individual health care provider with primary practice located at 302 University Pkwy , Aiken SC 29801-6302. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Ellis, Kim Marie can be contacted via phone (803) 641-5883.

Contact Information

Primary practice address
302 University Pkwy Aiken SC 29801-6302
Phone: (803) 641-5883
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN 20053 RX South Carolina

Profile Details

NPI number 1952762528
LBN Legal business name Ellis, Kim Marie
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2016
Last updated Jul 6th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952762528 NPPES
South Carolina MEDICAID NP3758

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