Individual
LAURIE A ELLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-PMHNP -BC
Contact information
Practice address
607 WASHINGTON HWY, MORRISVILLE, VT 05661-8652
(802) 888-8320
(802) 888-8136
Mailing address
PO BOX 749, MORRISVILLE, VT 05661-0749
(802) 851-8704
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
101.0134947
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6708137
—
VT
Enumeration date
09/02/2021
Last updated
10/14/2022
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