Individual
WENDY M ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
200 ST. MARY'S PLAZA, STE 301, JEFFERSON CITY, MO 65101
(573) 636-9000
Mailing address
616 BELMONT DR # B, JEFFERSON CITY, MO 65109-0718
(573) 634-2881
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2004004102
MO
Other
Enumeration date
08/07/2006
Last updated
07/08/2007
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