Individual
CAROLYN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1904 HIGHWAY 46 S, SUITE 3, DICKSON, TN 37055-7744
(615) 375-8469
Mailing address
2203 SANDRA DR, NASHVILLE, TN 37210-5031
(865) 406-2396
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
1087
AL
363AM0700X
Medical Physician Assistant
Primary
2879
TN
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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