Individual
SELENA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1909 KNOLLCREST DR, CLERMONT, FL 34711-5115
(352) 531-4624
Mailing address
1909 KNOLLCREST DR, CLERMONT, FL 34711-5115
(352) 531-4624
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9300293
FL
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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