Individual
TERRI DIANE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 ANDREWS AVE., FORT RUCKER, AL 36362-0000
(334) 255-7883
(334) 255-7090
Mailing address
301 ANDREWS AVE., FORT RUCKER, AL 36362-0000
(334) 255-7883
(334) 255-7090
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
1-061216
AL
Other
Enumeration date
02/14/2008
Last updated
02/14/2008
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