Individual
ELLMAN BARKLEY HOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3500 S LAFOUNTAIN ST, KOKOMO, IN 46902-3803
(765) 776-8444
Mailing address
800 GULICK ST, JONESBORO, IN 46938-1242
(765) 860-6769
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
28187323A
IN
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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