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Individual

ELLEN ELIZABETH FESMIRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNFA

Contact information

Practice address
10110 NW COUNTY ROAD 235, ALACHUA, FL 32615-6660
(386) 462-7346
(386) 462-7381
Mailing address
10110 NW COUNTY ROAD 235, ALACHUA, FL 32615-6660
(386) 462-7346
(386) 462-7381

Taxonomy

Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
897992
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
227801
AVMED
FL
01
Y4737
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/29/2007
Last updated
07/08/2007
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