NPI 1376013326

Jimmy Lee Ellis

Practitioner Adult Companion Avondale, AZ

Practice location

Address: 105 N Links Dr APT 1061, Avondale, AZ 85323-3046
Phone: (480) 487-8480
Mailing address: 3420 E Shea Blvd STE 204, Phoenix, AZ 85028-3345

Registered specialties (3)

Adult Companion Primary

Nursing Service Related Providers Taxonomy 372600000X

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Home Health Aide

Nursing Service Related Providers Taxonomy 374U00000X

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Homemaker

Nursing Service Related Providers Taxonomy 376J00000X

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Registry record

NPI: 1376013326
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Dec 2018
Record last updated: 5 Jan 2019

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.