MILES ELLSWORTH

MARSHFIELD, WI
NPI1841703402
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy163WC0200X Registered Nurse, Critical Care Medicine
(Licence: MI  4704295031)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
(Licence: FL  RN9418207)
Enumeration Date2017-11-06
Last Update Date2017-11-06
Business Address
MILES ELLSWORTH SRNA
1000 N OAK AVE
MARSHFIELD, WI 54449-5703
Phone number: 715-387-5511
Mailing Address
MILES ELLSWORTH SRNA
16227 RAVINA WAY
NAPLES, FL 34110-3269
Phone number: 231-633-1829