Individual
GWYNDOLYN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, LAT, ATC
Contact information
Practice address
1600 CAMPUS CT, ABILENE, TX 79699-5318
(325) 674-2323
Mailing address
1290 CANTERBURY DR, ABILENE, TX 79602-4258
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
922427
TX
2255A2300X
Athletic Trainer
Primary
AT7218
TX
Other
Enumeration date
04/24/2018
Last updated
10/20/2024
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