Individual
MS. ADRIENNE MICHELE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1130 MIDLAND TER, DURHAM, NC 27704-5140
(919) 236-7507
Mailing address
1130 MIDLAND TER, DURHAM, NC 27704-5140
(919) 236-7507
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
064514
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
064514
NURSING LICENSE
NC
Enumeration date
02/17/2010
Last updated
02/17/2010
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