Whalio Doctors

NPI 1346685575

Kathleen Marie Ellis, LPTA

Practitioner Nursing Facility/Intermediate Care Facility Fenton, MI

Practice location

Address
512 Beach St, Fenton, MI 48430-3122
Phone
(810) 629-4117
Mailing address
11182 E Richfield Rd, Davison, MI 48423-8517

Registered specialties

Nursing Facility/Intermediate Care Facility Primary
Nursing & Custodial Care Facilities Taxonomy 313M00000X Licence 5502001225 (MI)

Registry record

NPI
1346685575
Entity type
Individual
Sex (as registered)
Female
NPI issued
1 May 2013
Record last updated
1 May 2013

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.