NPI 1104661107

Aquanita Sheretta Ellis

Practitioner Home Health Aide Phenix City, AL

Practice location

Address: 808 20th St, Phenix City, AL 36867-4525
Phone: (706) 302-9291
Mailing address: 1007 Samford CT APT B, Opelika, AL 36801-9782

Registered specialties (3)

Home Health Aide Primary

Nursing Service Related Providers Taxonomy 374U00000X

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In Home Supportive Care Agency

Agencies Taxonomy 253Z00000X

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Attendant Care Provider

Nursing Service Related Providers Taxonomy 3747A0650X

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Registry record

NPI: 1104661107
Entity type: Individual
Sex (as registered): Female
NPI issued: 1 Jul 2024
Record last updated: 11 Jul 2024

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.