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1578747085
ELLEN B ELLICKSON
SAINT CLOUD, MN
NPI
1578747085
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: MN R 059057-8)
Enumeration Date
2007-12-19
Last Update Date
2007-12-19
Business Address
Ms. ELLEN B ELLICKSON CNP
1245 15TH ST N
SAINT CLOUD, MN 56303-1802
Phone number: 320-203-2087
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Mailing Address
Ms. ELLEN B ELLICKSON CNP
1245 15TH ST N
SAINT CLOUD, MN 56303-1802
Phone number: 320-203-2087
Copy
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