Lori Ellis

NPI #1316570203 in Portage, Michigan

Provider Information

NPI Number: 1316570203
Entity Type: Individual
Name: Lori Ellis
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Registered Nurse
Enumeration Date: Feb 19, 2020
Last Updated: Feb 19, 2020

Practice Location

Address: 524 W CENTRE AVE
City: Portage
State: Michigan
ZIP Code: 49024-5306
Phone: (269) 324-1180

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary

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