MEDICARE: CYNTHIA R ELLIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	0000083514	TN
2	363L00000X	Nurse Practitioner	0000016607	TN

General Provider Information

NPI Number	:	1831439538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA R ELLIS

Provider Business Mailing Address
First Line	:	621 OLD HICKORY BLVD STE G
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-2911
Country	:	US
Telephone Number	:	731-660-6402
Fax Number	:	731-664-6603

Provider Business Practice Location Address
First Line	:	621 OLD HICKORY BLVD STE G
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-2911
Country	:	US
Telephone Number	:	731-660-6402
Fax Number	:	731-664-6603

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2013
Last Update Date	:	02/18/2013

Similar Medicare Providers

1780789289 — DEBRA SUSAN NASH LCSW
Practice Location Address:

621 OLD HICKORY BLVD STE E
JACKSON, TN
38305-2911

Practice Phone: 731-660-6402
Practice Fax:

1811028475 — HEATHER N MCFARLAND
Practice Location Address:

621 OLD HICKORY BLVD STE G
JACKSON, TN
38305-2911

Practice Phone: 731-660-6402
Practice Fax: 731-664-6603

1326108770 — DONG NAI PHARMACY
Practice Location Address:

620 S JACKSON ST
SEATTLE, WA
98104-2911

Practice Phone: 206-624-4238
Practice Fax: 206-682-2089

1891147583 — MS. RACHEL HAMILTON
Practice Location Address:

2911 ASHTON RIDGE DR APT 4
JACKSON, MI
49201-7569

Practice Phone: 517-513-0290
Practice Fax:

1699315275 — CHARLIE FEIMAN YEN L.AC
Practice Location Address:

626 S JACKSON ST
SEATTLE, WA
98104-2911

Practice Phone: 206-696-9176
Practice Fax:

1730031881 — CORNERSTONE CAREGIVING EAST LLC
Practice Location Address:

1363 UNION UNIVERSITY DR STE D
JACKSON, TN
38305-3863

Practice Phone: 731-300-9036
Practice Fax:

Directions to “ CYNTHIA R ELLIS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.