Provider Demographics
NPI:1093502932
Name:ELLIS RUSSELL, JAHANNA RAPHINE (MBBS)
Entity type:Individual
Prefix:MRS
First Name:JAHANNA
Middle Name:RAPHINE
Last Name:ELLIS RUSSELL
Suffix:
Gender:
Credentials:MBBS
Other - Prefix:MS
Other - First Name:JAHANNA
Other - Middle Name:RAPHINE
Other - Last Name:ELLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:32 DULWICH DRIVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON 8
Mailing Address - State:KINGSTON
Mailing Address - Zip Code:00000
Mailing Address - Country:JM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:32 DULWICH DRIVE
Practice Address - Street 2:
Practice Address - City:KINGSTON 8
Practice Address - State:KINGSTON
Practice Address - Zip Code:00000
Practice Address - Country:JM
Practice Address - Phone:876-790-6476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program