Individual
MS. ELLEN MARY MCKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1 MEDICAL CENTER DR, DHMC GENERAL SURGERY, LEBANON, NH 03756-1000
(603) 650-8022
Mailing address
1 MEDICAL CENTER DR, DHMC GENERAL SURGERY, LEBANON, NH 03756-1000
(603) 650-8022
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
032812-23-12
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009685
—
VT
Enumeration date
10/19/2006
Last updated
07/16/2007
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