Individual
MRS. YASMIN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
620 GALLATIN PIKE S, MADISON, TN 37115-4013
(615) 460-4300
Mailing address
1157 LAKEWALK DR, ANTIOCH, TN 37013-2442
(615) 587-2216
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0000078268
TN
Other
Enumeration date
02/11/2016
Last updated
02/11/2016
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