Individual
KIRSTEN MARIE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4977 NORTHCUTT PL, DAYTON, OH 45414-3839
(513) 237-1981
Mailing address
6272 SHEARWATER DR, FAIRFIELD, OH 45014-4926
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
1157133
KY
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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