Individual
HANNAH NICOLE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1124 MAIN AVE, DIERKS, AR 71833-9421
(870) 784-0884
(870) 825-2060
Mailing address
PO BOX 575, DIERKS, AR 71833-0575
(870) 784-0884
(870) 825-2060
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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