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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00000 | Medicaid | LA |
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- Wendy R Devall
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- Ariel Nashandra Gilbert-Pate
- Eboni Harris
- Brian P Higgins
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All providers in Brusly, LA · Case Manager/Care Coordinator in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.