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1760945448
JACQUELYN B ELLISON
PASCAGOULA, MS
NPI
1760945448
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MS 903206)
Enumeration Date
2019-04-10
Last Update Date
2019-04-10
Business Address
JACQUELYN B ELLISON FNP, NP-C
4105 HOSPITAL ROAD, STE 103
PASCAGOULA, MS 39581
Phone number: 228-762-8712
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Mailing Address
JACQUELYN B ELLISON FNP, NP-C
116 MILL STREET EXT
LUCEDALE, MS 39452-3492
Phone number:
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