Individual
SHAQUITA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
114A OAK CIR, MONROE, LA 71203-2722
(318) 816-3835
Mailing address
114A OAK CIR, MONROE, LA 71203-2722
(318) 816-3835
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
213569
LA
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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