Provider Demographics
NPI:1295441541
Name:STONE, ELLEN (MOBILE PHLEBOTOMIST)
Entity type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:MOBILE PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2674 NEW HOPE CICLE
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815
Mailing Address - Country:US
Mailing Address - Phone:706-550-2737
Mailing Address - Fax:
Practice Address - Street 1:2674 NEW HOPE CICLE
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815
Practice Address - Country:US
Practice Address - Phone:706-550-2737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA397-10732246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty