Individual
LORI KAYE ELLENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
123 WG ACKER DR STE B, PICKENS, SC 29671-2739
(864) 878-2435
Mailing address
PO BOX 919, PICKENS, SC 29671-0919
(864) 897-8286
(864) 878-0035
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
21169
SC
Other
Enumeration date
08/30/2017
Last updated
10/11/2018
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