Individual
DANIELLA S ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
11273 HIGHWAY 61 N, ROBINSONVILLE, MS 38664-9705
(662) 357-0012
(662) 357-0021
Mailing address
PO BOX 789, TUNICA, MS 38676-0789
(662) 357-0012
(662) 357-0021
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R87-3851
MS
Other
Enumeration date
10/17/2006
Last updated
08/12/2013
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