Individual
SALLIE R. ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
1105 WOODSTOCK AVENUE, ANNISTON, AL 36207-4208
(256) 240-7272
(256) 240-7242
Mailing address
1105 WOODSTOCK AVENUE, ANNISTON, AL 36207-4208
(256) 240-7272
(256) 240-7242
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
C08-0119A
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51548269
BLUE CROSS BLUE SHIELD
AL
Enumeration date
05/16/2008
Last updated
05/04/2018
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