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Individual
JANA LEIGH ELLIS IX
Active
Individual
JANA LEIGH ELLIS IX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202216556
VA
183500000X
Pharmacist
Primary
PD10867
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202216556
PHARMACIST LICENSE
VA
01
—
PD10867
PHARMACIST LICENSE
AR
Enumeration date
04/29/2022
Last updated
04/29/2022
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