Demetria Ellis
Individual provider Active NPI Driver · Emporia, VA
NPI 1972164564 · NPPES record last updated Jun 24, 2019
Key facts
- NPI
- 1972164564
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 710 Evans St
Emporia, VA 23847-1358 - Phone
- (434) 532-9303
- NPI assigned
- Jun 24, 2019
- 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 |
|---|---|---|---|---|
| Driver | 172A00000X | VA | Yes |
Addresses
Primary practice location
710 Evans St
Emporia, VA 23847-1358
Mailing address
710 Evans St
Emporia, VA 23847-1358
Phone (434) 532-9303
Other providers in Emporia, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2019. 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.