Individual
KYLIE ALYSSA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
795 POPLAR RD STE 400, NEWNAN, GA 30265-2590
(770) 716-0051
Mailing address
795 POPLAR RD STE 400, NEWNAN, GA 30265-2590
(770) 716-0051
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN239284
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN239284
GA
Other
Enumeration date
02/19/2020
Last updated
10/20/2022
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