Individual
MS. JEAN ANN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
Mailing address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
730354
TX
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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