Individual
MRS. MARY ILEEN ELLIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNFA
Contact information
Practice address
76 BROOKWOOD AVE, SANTA ROSA AMBULATORY SURGERY CENTER, SANTA ROSA, CA 95404
(510) 970-5000
Mailing address
PO BOX 1288, HEALDSBURG, CA 95448
(707) 433-6279
(707) 433-6279
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
321165
CA
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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