Individual
MERCEDES ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2477 WAITS RIVER RD, BRADFORD, VT 05033-8104
(603) 667-8337
Mailing address
2477 WAITS RIVER RD, BRADFORD, VT 05033-8104
(603) 667-8337
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
026.0146370
VT
164W00000X
Licensed Practical Nurse
025.0135464
VT
Other
Enumeration date
03/18/2021
Last updated
06/28/2021
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