Individual
DONNA A THOMAS ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1040 N FLOWOOD DR STE 100, FLOWOOD, MS 39232-9789
(601) 933-5417
Mailing address
PO BOX 321359, FLOWOOD, MS 39232-1359
(601) 933-5417
(601) 936-1336
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
602612
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05457378
—
MS
Enumeration date
12/04/2006
Last updated
03/24/2022
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