Individual
CRYSTAL MANN-ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1504 SANTA ROSA RD RM 114, HENRICO, VA 23229-5109
(804) 210-3103
(804) 210-3104
Mailing address
1504 SANTA ROSA RD RM 114, HENRICO, VA 23229-5109
(804) 210-3101
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024174547
VA
Other
Enumeration date
02/18/2017
Last updated
08/20/2024
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