Individual
MATTIE ROSE ELLENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
49725 COUNTY 83, STAPLES, MN 56479-5280
(218) 894-1515
(218) 898-7518
Mailing address
49725 COUNTY 83, STAPLES, MN 56479-5280
(218) 894-1515
(218) 898-7518
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
12090
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
518853900
—
MN
Enumeration date
02/07/2020
Last updated
09/23/2025
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