Individual
JESSICA ELLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 NEW YORK AVE, SUITE 150, OAK RIDGE, TN 37830-5212
(865) 835-5196
(865) 835-5197
Mailing address
200 NEW YORK AVE, SUITE 150, OAK RIDGE, TN 37830-5212
(865) 835-5196
(865) 835-5197
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22195
TN
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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