Individual
CHRISTINE A ELLINGSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
81 CHURCH STREET, ALEXANDRIA, NY 13607
(315) 482-9719
Mailing address
219 SAINT MARY ST, WATERTOWN, NY 13601-2136
(315) 785-9148
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
134871-1
NY
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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