Individual
KEZIA LYNNETTE ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11110 MEDICAL CAMPUS RD STE 200, HAGERSTOWN, MD 21742-6797
(301) 790-9240
Mailing address
11110 MEDICAL CAMPUS RD STE 200, HAGERSTOWN, MD 21742-6797
(301) 790-9240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D094743
MD
Other
Enumeration date
05/16/2019
Last updated
07/22/2022
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