Individual
DEIRDRE WOOLSEY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1110 TAMIAMI TRL N, NOKOMIS, FL 34275-2158
(727) 766-0000
(941) 200-3932
Mailing address
20905 PROFESSIONAL PLAZA, SUITE 330, ASHBURN, VA 20147
(703) 726-0003
(703) 726-6444
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110002387
VA
363A00000X
Physician Assistant
Primary
PA9112912
FL
Other
Enumeration date
11/07/2006
Last updated
02/21/2023
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