Individual
MRS. CAROLINE SUZANNE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
710 E AVE, FAMILY MEDICINE, CARRIZOZO, NM 88301-0008
(575) 648-2317
(575) 648-4413
Mailing address
PO BOX 26666, ALBUQUERQUE, NM 87125-6666
(575) 740-7449
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
81488
NM
Other
Enumeration date
10/28/2024
Last updated
11/20/2024
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