Individual
SUSAN D ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5629 STADIUM DR STE D, KALAMAZOO, MI 49009-1952
(269) 372-5701
(269) 372-5702
Mailing address
5629 STADIUM DR STE D, KALAMAZOO, MI 49009-1952
(269) 372-5701
(269) 372-5702
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
470422171
MI
Other
Enumeration date
04/08/2020
Last updated
04/08/2020
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