Individual
ASHLEY RENEE WALKER-ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
900 W NIFONG BLVD STE 100, COLUMBIA, MO 65203-4469
(573) 815-6631
Mailing address
515 WESTERN DR, MACON, MO 63552-1041
(217) 779-3465
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209019031
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091685
—
IL
Enumeration date
03/18/2019
Last updated
11/09/2021
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