Individual
KAYLA ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
57 SEDGEWICK TRL, PALM COAST, FL 32164-5431
(386) 338-8760
Mailing address
57 SEDGEWICK TRL, PALM COAST, FL 32164-5431
(386) 338-8760
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
230496
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
626430
—
FL
Enumeration date
08/15/2016
Last updated
08/15/2016
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