HARLEY LYELL ELLIS

BRAINERD, MN
NPI1568536142
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MN  R 092367-9)
Enumeration Date2006-11-17
Last Update Date2007-07-08
Business Address
-- HARLEY LYELL ELLIS RN, CNP
11855 STATE AVE C.O.R.E. BRAINERD
BRAINERD, MN 56401-4127
Phone number: 218-828-2389
Mailing Address
-- HARLEY LYELL ELLIS RN, CNP
1121 8TH ST S
BRAINERD, MN 56401-4127
Phone number: 218-829-0895
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