Individual
KIMBERLY MAXINE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2070 CENTURY PARK E, LOS ANGELES, CA 90067-1907
(424) 522-7100
Mailing address
4714 GETTYSBURG RD, MECHANICSBURG, PA 17055-4325
(717) 920-4047
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
01122219
CA
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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