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General NPI Number Information
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NPI Number | 1568309151
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Entity Type | Individual
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Provider Name | JESSICA ROSE ELLIS RN
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Gender | Female
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Dates
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Enumeration Date | 05/01/2026
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Last Update Date | 05/01/2026
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Provider Practice Location Address
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Address Line | 455 PINELLAS ST STE 400
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City | CLEARWATER
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State | FL
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Zip | 33756-3356
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Country | US
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Telephone | 727-445-1911
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Fax | 727-445-1987
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Provider Business Mailing Address
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Address Line | 707 24TH ST SW
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City | LARGO
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State | FL
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Zip | 33770-2957
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Country | US
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Telephone | 813-727-9510
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Fax | 727-445-1987
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9244603
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License Number State | FL
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