Individual
MICHELLE RENEE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1570 WAVERLY RD, KINGSPORT, TN 37664-2523
(423) 224-1300
(423) 224-1325
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN149104
TN
Other
Enumeration date
05/19/2008
Last updated
05/19/2008
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