Individual
PAMELA JEAN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,CRNA
Contact information
Practice address
1805 HENNEPIN AVE N, GLENCOE, MN 55336-1416
(320) 864-3121
Mailing address
1805 HENNEPIN AVE N, GLENCOE, MN 55336-1416
(320) 864-7812
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
136088-8
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
1982
MN
Other
Enumeration date
02/23/2011
Last updated
11/15/2023
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