Individual
LEEANN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6420 POLLARDS POND RD, APPLING, GA 30802-3726
(706) 447-7693
(706) 868-3336
Mailing address
231 OLEANDER TRL, EVANS, GA 30809-5135
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN044588
GA
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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