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Individual

ELLEN MARIE BOERSMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
5150 HILL RD E, #F, LAKEPORT, CA 95453-5101
(707) 262-3060
Mailing address
5150 HILL RD E, #F, LAKEPORT, CA 95453-5101
(707) 262-3060

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
18609
CA

Other

Enumeration date
10/16/2008
Last updated
10/16/2008
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