Individual
LEE ALLEN ELLINGSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
415 JEFFERSON ST N, WADENA, MN 56482-1264
(218) 631-7589
Mailing address
10170 180TH ST, WADENA, MN 56482-4094
(218) 631-9054
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R1388019
MN
367500000X
Certified Registered Nurse Anesthetist
R23296
ND
Other
Enumeration date
07/18/2006
Last updated
02/14/2008
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