Crystal Berniece Ellis

NPI #1710320379 in Joint Base Lewis Mcchord, Washington

Provider Information

NPI Number: 1710320379
Entity Type: Individual
Name: Crystal Berniece Ellis
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Apr 14, 2013
Last Updated: Apr 14, 2013

Practice Location

Address: 9040 FITZSIMMONS DR
City: Joint Base Lewis Mcchord
State: Washington
ZIP Code: 98431-1000
Phone: (253) 968-1920

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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