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Individual

MRS. ELLISON BETH DART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
10027 US 70 BUSINESS HWY W STE C, CLAYTON, NC 27520-2115
(919) 424-0062
(919) 704-3674
Mailing address
2885 OLD US 70 HWY W LOT 33, CLAYTON, NC 27520-6562
(919) 817-3373

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
228772
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5014036
NC

Other

Enumeration date
09/22/2014
Last updated
09/12/2022
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