| NPI | 1285076018 |
|---|---|
| Former Name | EMILY DIANE ELLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3008179) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3008179) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2018-12-05 |