Individual
DEVON SIMONE ELLENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
14655 GALAXIE AVE, APPLE VALLEY, MN 55124-8602
(952) 432-6161
(952) 891-3921
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-4400
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
7290
MN
363LG0600X
Gerontology Nurse Practitioner
7290
MN
Other
Enumeration date
03/04/2020
Last updated
10/07/2020
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