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1164058723
TISHA KIM ELLIS
FORT CARSON, CO
NPI
1164058723
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NE 113116)
Enumeration Date
2020-03-16
Last Update Date
2023-10-20
Business Address
Mrs. TISHA KIM ELLIS APRN, PMHNP-BC
1650 COCHRANE CIR
FORT CARSON, CO 80913-4613
Phone number: 719-526-0175
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Mailing Address
Mrs. TISHA KIM ELLIS APRN, PMHNP-BC
1650 COCHRANE CIR
FORT CARSON, CO 80913-4613
Phone number: 719-526-0175
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