Individual
ELISABETH LUISE GAMMELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 LAKE STATION, LAKE CLINIC, YELLOWSTONE NATIONAL PARK, WY 82190
(307) 242-7241
(307) 242-7273
Mailing address
283 N 1ST E, DRIGGS, ID 83422-5109
(208) 354-2302
(208) 354-8392
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-448
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806724500
—
ID
Enumeration date
11/06/2006
Last updated
06/02/2009
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