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1154819035
KATHRYN LOUISE ELLENS
GRAND RAPIDS, MI
NPI
1154819035
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Former Name
KATHRYN JIPPING
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: MI 4704278582)
Enumeration Date
2018-04-26
Last Update Date
2023-03-27
Business Address
KATHRYN LOUISE ELLENS NP
4100 LAKE DR SE STE 200
GRAND RAPIDS, MI 49546-8292
Phone number: 616-391-3759
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Mailing Address
KATHRYN LOUISE ELLENS NP
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number:
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