| NPI | 1558708776 |
|---|---|
| Former Name | COURTNEY A. ELLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VT 101.0095476) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0095476) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2015-11-19 |