Individual
MRS. JUNE A ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED ARNP
Contact information
Practice address
441 MAIN ST, KEENE, NH 03431
(603) 357-3565
(603) 352-4337
Mailing address
441 MAIN ST, KEENE, NH 03431
(603) 357-3565
(603) 352-4337
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0271892308
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
YGG0012345678
ANTHEM BCBS
—
05
—
YGG0012345678
—
NH
Enumeration date
12/26/2006
Last updated
07/08/2007
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