Individual
MRS. JOAN R ELLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1301 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-8420
(540) 741-3716
(540) 741-1096
Mailing address
2101 EAST JEFFERSON STREET PPQA MEDICARE COMPLIANCE UNI, KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP, ROCKVILLE, MD 20852-4908
(301) 816-6660
(301) 816-6308
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0001073375
VA
Other
Enumeration date
12/27/2006
Last updated
01/25/2012
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