Tonnisha Ellis

Individual provider Active NPI Case Manager/Care Coordinator · Brusly, LA

NPI 1396217337 · NPPES record last updated Dec 31, 2018

Key facts

NPI
1396217337
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
2699 Orleans Quarters Dr
Brusly, LA 70719-2190
Phone
(318) 308-3327
NPI assigned
Dec 31, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

2699 Orleans Quarters Dr
Brusly, LA 70719-2190

Mailing address

2699 Orleans Quarters Dr
Brusly, LA 70719-2190

Other identifiers

IdentifierTypeStateIssuer
00000MedicaidLA

Other providers in Brusly, LA

All providers in Brusly, LA · Case Manager/Care Coordinator in Louisiana

Sources for this page

Verify at the official NPI Registry.