Individual
ELISE GALVANIN-ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
149 GRANVILLE DRIVE, OTIS AIR NATIONAL GUARD BASE, BUZZARDS BAY, MA 02542
(508) 968-4091
Mailing address
149 GRANVILLE DRIVE, OTIS AIR NATIONAL GUARD BASE, BUZZARDS BAY, MA 02542-1808
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2287535
MA
Other
Enumeration date
07/27/2023
Last updated
02/08/2024
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