Nisly, Ross Ellis

Nisly, Ross Ellis is an individual health care provider with primary practice located at 2080 S E St #100, San Bernardino CA 92408-2706. He recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as his primary health care specialty. Nisly, Ross Ellis can be contacted via phone (909) 388-9191.

Contact Information

Primary practice address
2080 S E St #100 San Bernardino CA 92408-2706
Phone: (909) 388-9191
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 550198 California

Profile Details

NPI number 1982935763
LBN Legal business name Nisly, Ross Ellis
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2010
Last updated Jan 19th, 2010 - about 16 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 1982935763 NPPES
California MEDICAID 1124100383

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