TARA RUSSELL ELLIS

NORTH CHARLESTON, SC
NPI1659951739
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: SC  25495)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-04-12
Last Update Date2022-01-20
Business Address
TARA RUSSELL ELLIS NP
2680 ELMS PLANTATION BLVD
NORTH CHARLESTON, SC 29406-7101
Phone number: 843-439-6181
Mailing Address
TARA RUSSELL ELLIS NP
2680 ELMS PLANTATION BLVD
NORTH CHARLESTON, SC 29406-7101
Phone number: 843-813-2914