Individual
AMBER LACEY ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
250 DEWEY AVE, SPARTANBURG, SC 29303-3009
(864) 585-0366
Mailing address
250 DEWEY AVE, SPARTANBURG, SC 29303-3009
(864) 585-0366
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
226592
SC
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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