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1033208582
SUSIE A ELLENWOOD
LAPWAI, ID
NPI
1033208582
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: ID PN-9235)
Enumeration Date
2006-10-12
Last Update Date
2007-07-08
Business Address
SUSIE A ELLENWOOD LPN
111 BEVER GRADE
LAPWAI, ID 83540-0365
Phone number: 208-843-2271
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Mailing Address
SUSIE A ELLENWOOD LPN
PO BOX 201
LAPWAI, ID 83540-0201
Phone number: 208-843-9375
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