Individual
MRS. GWENDY JO ELLINGSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1220 SUNDANCE CT NE, BYRON, MN 55920-1573
(507) 993-6402
Mailing address
1220 SUNDANCE CT NE, BYRON, MN 55920-1573
(507) 993-6402
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201886-7
MN
Other
Enumeration date
04/04/2014
Last updated
06/11/2019
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