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General NPI Number Information
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NPI Number | 1124586623
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Entity Type | Individual
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Provider Name | JOY A ELLIS-GEORGE PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/04/2019
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 1400 MERCANTILE LN STE 252
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City | UPPER MARLBORO
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State | MD
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Zip | 20774-5333
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Country | US
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Telephone | 844-200-3273
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Fax |
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Provider Business Mailing Address
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Address Line | 1338 N CAPITOL ST NW
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City | WASHINGTON
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State | DC
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Zip | 20002-3396
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Country | US
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Telephone | 202-745-0073
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN1033878
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License Number State | DC
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