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1942302658
SHIRLEY B ELLSWORTH
PROVO, UT
NPI
1942302658
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: UT 2629084405)
Enumeration Date
2006-09-02
Last Update Date
2007-10-16
Business Address
SHIRLEY B ELLSWORTH NP
1055 N 500 W SUITE 202
PROVO, UT 84604-3305
Phone number: 801-374-2367
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Mailing Address
SHIRLEY B ELLSWORTH NP
1055 N 500 W CREDENTIALING DEPARTMENT
PROVO, UT 84604-3305
Phone number: 801-354-8215
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