Individual
SHERRY L ELLEFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1300 ANNE ST NW, BEMIDJI, MN 56601-5103
(218) 333-6011
(218) 333-6113
Mailing address
1300 ANNE ST NW, BEMIDJI, MN 56601-5103
(218) 333-6011
(218) 333-6113
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R1031751
MN
Other
Enumeration date
11/14/2006
Last updated
07/09/2007
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