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NPI Profile for DAN ELLIS GNP INC in PORT GIBSON, MS.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Gerontology |
363LG0600X | 50 | Nurse Practitioner |
| NPI Number | 1942552732 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 10/04/2012 | |
| Last updated | 12/26/2012 - About 13 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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DAN ELLIS GNP INC
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DAN ELLIS GNP INC