Individual
JASON G. ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2201 LEXINGTON AVE, ASHLAND, KY 41101-2843
(606) 408-4000
Mailing address
425 LEWIS HARGETT CIR, LEXINGTON, KY 40503-3590
(859) 268-1030
(859) 269-4120
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3010317
KY
Other
Enumeration date
06/02/2016
Last updated
06/02/2016
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