Individual
VICKI L ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
32 N LOCUST ST, TAMAROA, IL 62888-4206
(618) 357-0023
Mailing address
32 N LOCUST ST, TAMAROA, IL 62888-4206
(618) 357-0023
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041480234
IL
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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