Individual
HARRIETT ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8060 KNUE RD STE 110, INDIANAPOLIS, IN 46250-1938
(317) 842-7435
Mailing address
2924 CHARNOCK ST, INDIANAPOLIS, IN 46229-1012
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27050748A
IN
Other
Enumeration date
07/11/2007
Last updated
07/11/2007
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