Individual
KIMBERLY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
104 LOGAN ST, WILLIAMSON, WV 25661-3606
(304) 236-5902
(304) 235-8150
Mailing address
104 LOGAN ST, WILLIAMSON, WV 25661-3606
(304) 236-5902
(304) 235-8150
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
44540
WV
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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