| Mrs Latoya Ellis, | |
|
5452 Fort St Ste 200, Trenton, MI 48183-4638 | |
| (734) 642-2727 | |
| Not Available |
| Full Name | Mrs Latoya Ellis |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 5452 Fort St Ste 200, Trenton, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003465428 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 4704233922 (Michigan) | Secondary |
| 363L00000X | Nurse Practitioner | 4704233922 (Michigan) | Primary |
| Entity Name | Beaumont Medical Group- Specialty Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578072906 PECOS PAC ID: 7214299866 Enrollment ID: O20180320002549 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Latoya Ellis, 1663 Savannah Ct, Ypsilanti, MI 48198-3681 Ph: () - | Mrs Latoya Ellis, 5452 Fort St Ste 200, Trenton, MI 48183-4638 Ph: (734) 642-2727 |
Mr. Jerry Idiculla Chandy, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1675 Kingsway Ct Ste 1, Trenton, MI 48183 Phone: 734-676-8530 | |
Elizabeth Ann Davis, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5400 Fort St Ste 130, Trenton, MI 48183 Phone: 734-362-7100 Fax: 734-671-1768 | |
Staci Damiani, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1675 Kingsway Ct, Trenton, MI 48183 Phone: 734-676-8530 Fax: 734-676-2319 | |
Ms. Janet T Sohn, R.N. M.S. C.S. F.N.P Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5452 Fort St Ste 200, Trenton, MI 48183 Phone: 734-642-2727 | |
Samreen Haroon, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3645 West Rd, Trenton, MI 48183 Phone: 734-486-4200 Fax: 734-486-4202 | |
Yvonne Holton, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5450 Fort St, Trenton, MI 48183 Phone: 734-671-3800 |