NPI 1073930897
January Ellis-Bansode, DISMPH
Practice location
- Address
- 140 Dameron Ave, Knoxville, TN 37917-6413
- Phone
- (865) 215-5822
- Mailing address
- 201 W Springdale Ave, Knoxville, TN 37917-5158
Registered specialties
Community Health Worker
Primary
Registry record
- NPI
- 1073930897
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 19 Mar 2014
- Record last updated
- 31 Jan 2018
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.