Individual
JESSICA ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NTP, BSN, RN
Contact information
Practice address
160 LAKE RIDGE DR, TRUSSVILLE, AL 35173-3855
(205) 767-8980
Mailing address
160 LAKE RIDGE DR, TRUSSVILLE, AL 35173-3855
(205) 767-8980
Taxonomy
Speciality
Code
Description
License number
State
163WN1003X
Nutrition Support Registered Nurse
Primary
1-113555
AL
Other
Enumeration date
06/29/2026
Last updated
06/29/2026
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