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Individual

SUE A ELLWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
1740 CLEVELAND RD, WOOSTER, OH 44691-2204
(330) 287-4850
(330) 264-9804
Mailing address
1740 CLEVELAND RD, WOOSTER, OH 44691-2204
(330) 287-4500

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP05864
OH
363L00000X
Nurse Practitioner
RN168210
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2652713
OH
Enumeration date
04/21/2006
Last updated
03/03/2010
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