Individual
DONALD EDMUND ELLEFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
4204 TROPICANA DR, KILLEEN, TX 76549-4592
(254) 338-3621
Mailing address
903 COUNTY ROAD 4711, KEMPNER, TX 76539-5901
(402) 452-8188
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
21193
NE
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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