Individual
JAMIE JELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 COMMODORE ST, PRATT, KS 67124-2903
(620) 672-7451
(620) 672-2113
Mailing address
200 COMMODORE ST, PRATT, KS 67124-2903
(620) 672-7451
(620) 672-2113
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-77174
KS
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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