Individual
LORI LEE ELLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3314 PATRIOT CT, HERRIN, IL 62948
(618) 993-0056
(618) 993-0752
Mailing address
PO BOX 1105, INDIANAPOLIS, IN 46206-1105
(618) 549-5361
(618) 529-0568
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209010037
IL
Other
Enumeration date
01/03/2013
Last updated
08/15/2018
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