Provider Demographics
NPI:1700377645
Name:AMES, ELLA
Entity Type:Individual
Prefix:
First Name:ELLA
Middle Name:
Last Name:AMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 STEPHENS CT
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-6758
Mailing Address - Country:US
Mailing Address - Phone:919-920-2374
Mailing Address - Fax:
Practice Address - Street 1:110 S CENTER ST
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:NC
Practice Address - Zip Code:28365
Practice Address - Country:US
Practice Address - Phone:919-635-3344
Practice Address - Fax:919-635-3388
Is Sole Proprietor?:No
Enumeration Date:2018-05-26
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other