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1205094174
KIMBERLY CAROL ELLISON
WYTHEVILLE, VA
NPI
1205094174
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: VA 0024167810)
Enumeration Date
2008-05-28
Last Update Date
2021-10-26
Business Address
KIMBERLY CAROL ELLISON NP
770 W RIDGE RD STE 220
WYTHEVILLE, VA 24382-1187
Phone number: 276-223-3202
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Mailing Address
KIMBERLY CAROL ELLISON NP
770 W RIDGE RD
WYTHEVILLE, VA 24382-1187
Phone number: 276-223-3200
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