| NPI | 1487837001 |
|---|---|
| Other Name | ELLEN MAUREEN FONVILLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: WI 521) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R1692077) |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MN LAT104292845) | |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2011-08-15 |