JACKIE DWAYNE ELLINGTON EMT NPI 1841540754

NPI Information

Jackie Dwayne Ellington, EMT is an emergency medical technician intermediate in Ellijay, GA. The provider is an Intermediate EMT is an individual trained and certified to perform intermediate life support treatment in medical emergencies based on individual state boards. Jackie Dwayne Ellington, EMT NPI is 1841540754. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1548 OLD HWY 5 SOUTH
ELLIJAY, GA
ZIP 30540
Phone: (706) 273-7477
Fax: (706) 276-8474

The enumeration date for this NPI number is 9/18/2012 and was last updated on 9/18/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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