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Contact Information

ANDREA ELLIS
4144 DEL ROSA DR
JACKSON, MS39206-4732
 Phone: 601-572-5631
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Attendant Care Provider

3747A0650X
Indicates primary specialty

NPI Profile & details for ANDREA ELLIS · (Female)

NPI # 1376216861
Status Active
Credentials
Entity Individual
Enumeration date 07/29/2021
Last updated 07/29/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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