Individual
ALPHRETTA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4040 S EASTERN AVE STE 300, LAS VEGAS, NV 89119-0854
(313) 768-7334
Mailing address
13586 INDIANA ST, DETROIT, MI 48238-2308
(313) 768-7334
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
4703109056
MI
164W00000X
Licensed Practical Nurse
Primary
878975
NV
Other
Enumeration date
04/19/2016
Last updated
01/07/2025
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