Individual
MS. SUSAN CAPRI ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
716 E BRADFORD ST, MARION, IN 46952-2921
(765) 251-1508
Mailing address
716 E BRADFORD ST, MARION, IN 46952-2921
(765) 251-1508
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27041419A
IN
Other
Enumeration date
12/30/2006
Last updated
07/08/2007
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