Organization
MARY ELLINGTON APRN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY VIRGINIA ELLINGTON APRN (OWNER)
(270) 543-6372
Entity
Organization
Contact information
Practice address
1871 US HIGHWAY 41AS, DIXON, KY 42409-9448
(270) 543-6372
(270) 440-0007
Mailing address
1870 SHAKERAG RD, HANSON, KY 42413-9698
(270) 543-6372
(270) 440-0007
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/16/2025
Last updated
01/16/2025
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