Dan Ellis Gnp INC
NPI #1942552732 in Port Gibson, Mississippi
Provider Information
- NPI Number
- 1942552732
- Entity Type
- Organization
- Organization Name
- Dan Ellis Gnp INC
- Primary Specialty
- Nurse Practitioner - Gerontology
- Enumeration Date
- Oct 4, 2012
- Last Updated
- Dec 26, 2012
Practice Location
- Address
- 703B FARMER ST
- City
- Port Gibson
- State
- Mississippi
- ZIP Code
- 39150-2319
- Phone
- (601) 529-2871
Authorized Official
- Name
- DAN ELLIS
- Title
- PRESIDENT
- Phone
- (601) 636-0097
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Gerontology — Gerontology |
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