SANTINA MARIE ELLISON

BOISE, ID
NPI1932376936
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: ID  M-11508)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
207PE0004X Emergency Medicine Emergency Medical Services
(Licence: UT  7410499-1205)
Enumeration Date2008-05-09
Last Update Date2012-06-28
Business Address
SANTINA MARIE ELLISON M.D.
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2238
Mailing Address
SANTINA MARIE ELLISON M.D.
13960 W WAINWRIGHT DR
BOISE, ID 83713-1969
Phone number: 208-384-9022