NPI 1023685963

Jaquan Ellis

Practitioner Home Health Aide Hopkins, MN

Practice location

Address: 312 Jackson Ave N, Hopkins, MN 55343-8306
Phone: (651) 508-6356

Registered specialties

Home Health Aide Primary

Nursing Service Related Providers Taxonomy 374U00000X Licence PCA78474320190817 (MN)

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Registry record

NPI: 1023685963
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Jun 2021
Record last updated: 9 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.