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Individual

DONNA ELLENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
737 BROADWAY N, FARGO, ND 58102-4421
(701) 234-2251
Mailing address
PO BOX 2010, FARGO, ND 58122-0001
(701) 234-2251

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAC0198
ND

Other

Enumeration date
12/21/2010
Last updated
12/21/2010
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