Individual
MRS. LATOYA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5452 FORT ST STE 200, TRENTON, MI 48183-4638
(734) 642-2727
Mailing address
1663 SAVANNAH CT, YPSILANTI, MI 48198-3681
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704233922
MI
363LF0000X
Family Nurse Practitioner
4704233922
MI
Other
Enumeration date
09/09/2019
Last updated
11/14/2022
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