Individual
CORTNEY SHANTRES ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 EVANS DR, BELTON, SC 29627-9464
(864) 356-4598
Mailing address
300 BRITTANY PARK, ANDERSON, SC 29621-1565
(864) 356-4598
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2019050719
SC
363LF0000X
Family Nurse Practitioner
23492
SC
Other
Enumeration date
11/14/2019
Last updated
07/25/2023
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