Individual
ALEISHA SHONTE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1627 DONOVANS RDG NW, KENNESAW, GA 30152-7693
(404) 983-2484
Mailing address
1627 DONOVANS RDG NW, KENNESAW, GA 30152-7693
(404) 983-2484
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN074894
GA
Other
Enumeration date
09/21/2021
Last updated
09/21/2021
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