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General NPI Number Information
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NPI Number | 1952842536
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Entity Type | Individual
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Provider Name | ERIKA JAMBAL ELLIS NP
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Gender | Female
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Dates
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Enumeration Date | 03/15/2017
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | 1700 17TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20009-2453
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Country | US
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Telephone | 202-483-4400
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Fax | 540-338-1975
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Provider Business Mailing Address
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Address Line | 17336 PICKWICK DR
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City | PURCELLVILLE
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State | VA
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Zip | 20132-6179
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024174622
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN1040936
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License Number State | DC
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