Individual
JOHN A. ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-3023
(248) 858-3022
Mailing address
744 W MICHIGAN AVE, PO BOX 1123, JACKSON, MI 49201-1909
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704JA230495
MI
Other
Enumeration date
08/22/2006
Last updated
11/16/2017
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