Individual
MRS. KYNDRA LENEE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, NNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
154735
GA
363LN0000X
Neonatal Nurse Practitioner
Primary
RN154735
GA
Other
Enumeration date
05/19/2008
Last updated
10/31/2016
Update your record
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