Tina R Ellison, PA-C
NPI #1033196571 in Palm Coast, Florida
Provider Information
- NPI Number
- 1033196571
- Entity Type
- Individual
- Name
- Tina R Ellison, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Dec 27, 2005
- Last Updated
- Sep 17, 2024
Practice Location
- Address
- 61 MEMORIAL MEDICAL PKWY STE 1-800A
- City
- Palm Coast
- State
- Florida
- ZIP Code
- 32164-5983
- Phone
- (386) 302-1365
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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