Individual
MR. SHAWN ARCHIE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1780 E PARNALL RD, JACKSON, MI 49201-7136
(517) 780-6357
Mailing address
1780 E PARNALL RD, JACKSON, MI 49201-7136
(517) 780-6357
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704362684
MI
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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