Individual
JAMISE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
147 MOCKINGBIRD RD, DAVENPORT, FL 33896-4764
(863) 214-6738
Mailing address
PO BOX 4067, SEBRING, FL 33871-4067
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
08/26/2014
Last updated
08/26/2014
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