Nicolas Robert Ellsworth

NPI #1477365823 in Maryville, Tennessee

Provider Information

NPI Number
1477365823
Entity Type
Individual
Name
Nicolas Robert Ellsworth
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Physician Assistant
Enumeration Date
Jan 23, 2025
Last Updated
Jan 23, 2025

Practice Location

Address
1610 MADISON AVE
ZIP Code
37804-2931
Phone
(480) 322-5741

Specialties & Taxonomy Codes

Specialty
Physician Assistant

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