K Ellis Pa | |
120 Madeira Dr Ne Albuquerque NM 87108-1522 | |
(505) 546-4320 | |
(505) 546-4325 |
Full Name | K Ellis Pa |
---|---|
Speciality | Clinic/center |
Location | 120 Madeira Dr Ne, Albuquerque, New Mexico |
Authorized Official Name and Position | Keisha Ellis (AUTHORIZED OFFICIAL/OWNER) |
Authorized Official Contact | 9543353131 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
K Ellis Pa 515 E Las Olas Blvd Ste 120 Fort Lauderdale FL 33301-4261 Ph: (505) 546-4320 | K Ellis Pa 120 Madeira Dr Ne Albuquerque NM 87108-1522 Ph: (505) 546-4320 |
NPI Number | 1124885348 |
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Provider Enumeration Date | 03/04/2024 |
Last Update Date | 03/04/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124885348 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
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