SUSIE A ELLENWOOD

LAPWAI, ID
NPI1033208582
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: ID  PN-9235)
Enumeration Date2006-10-12
Last Update Date2007-07-08
Business Address
-- SUSIE A ELLENWOOD lpn
111 BEVER GRADE
LAPWAI, ID 83540-0365
Phone number: 208-843-2271
Mailing Address
-- SUSIE A ELLENWOOD lpn
PO BOX 201
LAPWAI, ID 83540-0201
Phone number: 208-843-9375
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