| NPI | 1790106813 |
|---|---|
| Former Name | ELLEN CONNOLLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 67910) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60396775) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60396775) | |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2021-12-30 |