NPI 1033208582

Susie a Ellenwood, LPN

Practitioner Licensed Practical Nurse Lapwai, ID

Practice location

Address: 111 Bever Grade, Lapwai, ID 83540-0365
Phone: (208) 843-2271
Mailing address: PO Box 201, Lapwai, ID 83540-0201

Registered specialties

Licensed Practical Nurse Primary

Nursing Service Providers Taxonomy 164W00000X Licence PN-9235 (ID)

Other Licensed Practical Nurse providers in Idaho →

Registry record

NPI: 1033208582
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Oct 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.