Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 2020019054 | MO |
NPI | 1003433525 |
---|---|
Provider Name | Dr. Lindsey Taylor Ellis |
First Address | Columbia, MO 65201-6986 |
Second Address | Columbia, MO 65201-6986 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2020 |
Last Update Date | 30/06/2020 |