Individual
JAMIE LOU ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
25 S RIVER RD, BEDFORD, NH 03110-6715
(603) 695-2572
Mailing address
25 S RIVER RD, BEDFORD, NH 03110-6715
(603) 695-2572
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
026952-23-03
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30342201
—
NH
Enumeration date
06/13/2006
Last updated
11/17/2011
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