Individual
ERICA ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
306 LANE ST, MAXTON, NC 28364-2620
(910) 318-6934
Mailing address
103 N GILL ST, LAURINBURG, NC 28352-3056
(910) 905-2935
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
281802
NC
Other
Enumeration date
05/05/2023
Last updated
05/05/2023
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