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Individual

BRIAN ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1100 TUNNEL RD, ASHEVILLE, NC 28805-2043
(828) 298-7911
Mailing address
27 BLUEBERRY LN, FAIRVIEW, NC 28730-9760

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
189652
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
AN2319
SC
Enumeration date
05/31/2010
Last updated
01/22/2014
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