Individual
MS. TIERRA LASHAY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1315 WINONA CT, DENVER, CO 80204-1138
(720) 403-6669
Mailing address
PO BOX 140574, DENVER, CO 80214-0574
(720) 689-3301
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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