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Individual

ELLEN D WILLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
31983
MN
208M00000X
Hospitalist Physician
Primary
31983
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
312821100
MN
Enumeration date
02/20/2006
Last updated
01/30/2018
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