Individual
MRS. AMBER ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
140 STOLLINGS AVE, SUITE 3, LOGAN, WV 25601-4035
(304) 752-4594
Mailing address
140 STOLLINGS AVE, SUITE 3, LOGAN, WV 25601-4035
(304) 752-4594
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
61591
WV
Other
Enumeration date
09/24/2009
Last updated
09/09/2011
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