DAN ELLIS GNP INC
NPI 1942552732
Nurse Practitioner - Gerontology in Port Gibson, MS
Active since October 04, 2012
About Dan Ellis Gnp Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAN ELLIS GNP INC (NPI 1942552732) is a healthcare organization registered as a gerontology in Port Gibson, Mississippi and active in the NPI registry since October 2012. The organization lists Dan Ellis, President, as its authorized official.
NPPES Registry Identity
NPI1942552732
Entity TypeOrganization
Primary Taxonomy363LG0600X
Legal Business NameDAN ELLIS GNP INC
Location Address703B FARMER STPort Gibson, MS 39150-2319
Mailing AddressPo Box 215Utica, MS 39175-0215 · (601) 529-2871 · Fax (601) 629-9969
Phone(601) 529-2871
Fax(601) 629-9969
Organization SubpartNo
Authorized OfficialDan EllisPresident · (601) 636-0097
Enumeration DateOctober 4, 2012
Last NPPES UpdateDecember 26, 2012
✔ NPI 1942552732 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in MS · R826981
703B FARMER ST, Port Gibson, MS 39150
Group Practice 1
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1942552732, enumerated as an "organization" on October 04, 2012.
The provider is located at 703B FARMER ST PORT GIBSON, MS 39150 and the phone number is (601) 529-2871.
Nurse Practitioner with taxonomy code 363LG0600X and a focus in Gerontology.
