Individual
ALENCIA C ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
8770 ELTON C HARRISON DRIVE, BATON ROUGE, LA 70813-3743
(225) 771-4770
(225) 771-6225
Mailing address
8770 ELTON C HARRISON DRIVE, BATON ROUGE, LA 70813-0001
(225) 771-4770
(225) 771-6225
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.200069
LA
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1099210
—
LA
Enumeration date
05/31/2006
Last updated
01/30/2024
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