Individual
KIMBERLY LYNN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
2220 N DRUID HILLS RD NE, ATLANTA, GA 30329-3117
(404) 785-5437
Mailing address
777 MEMORIAL DR SE UNIT 1421, ATLANTA, GA 30316-1789
(914) 500-9663
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
APRN-NP315883
GA
Other
Enumeration date
04/09/2026
Last updated
04/09/2026
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