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Individual
LAUREN NICOLE ELLIS
Active
Individual
LAUREN NICOLE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07311
TX
363A00000X
Physician Assistant
—
—
Other
Enumeration date
04/21/2011
Last updated
08/07/2014
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