Individual
LATONIYA CHEVELLE ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
819 DA VINCI ST, DURHAM, NC 27704-3341
(919) 593-1592
Mailing address
819 DA VINCI ST, DURHAM, NC 27704-3341
(919) 593-1592
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
53253
NC
253Z00000X
In Home Supportive Care Agency
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Other
Enumeration date
07/06/2020
Last updated
07/06/2020
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