Ellison, Tina R

Ellison, Tina R is an individual health care provider with primary practice located at 2626 Care Dr Ste 105 , Tallahassee FL 32308-4489. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Ellison, Tina R can be contacted via phone (850) 402-3104.

Contact Information

Primary practice address
2626 Care Dr Ste 105 Tallahassee FL 32308-4489
Phone: (850) 402-3104
Fax: (850) 402-9979
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 50-001637 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9117754 Florida

Profile Details

NPI number 1033196571
LBN Legal business name Ellison, Tina R
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2005
Last updated Feb 8th, 2024 - about 2 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 1033196571 NPPES
Ohio Other P00079777 RAILROAD MEDICARE
Ohio Other 000000316099 RAILROAD MEDICARE

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