Individual
ERIN ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 GORDON ST, BREMEN, GA 30110-1519
(770) 537-1234
Mailing address
631 GRADY WHITTON RD, BREMEN, GA 30110-3573
(404) 697-9529
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN198477
GA
363LF0000X
Family Nurse Practitioner
RN198477
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861915647
GROUP NPI
GA
Enumeration date
01/24/2013
Last updated
03/26/2025
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