Individual
MRS. AUTUMN DENISE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
320 S CHURCH ST, HALLS, TN 38040-1510
(731) 836-9303
Mailing address
3189 GARRETT BALL RD, GATES, TN 38037-5206
(731) 694-2872
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
29129
TN
Other
Enumeration date
03/19/2021
Last updated
03/19/2021
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