Organization
DEBORAH A ELLISON APRN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH ELLISON (APRN)
(860) 368-9213
Entity
Organization
Contact information
Practice address
901 MAIN ST, @AXIS901, MANCHESTER, CT 06040-6008
(860) 634-5342
Mailing address
901 MAIN ST, @AXIS901, MANCHESTER, CT 06040-6008
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/26/2016
Last updated
02/26/2016
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