Individual
AMY ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1751 E GARRY AVE, SANTA ANA, CA 92705-5814
(877) 896-7350
Mailing address
1751 E GARRY AVE, SANTA ANA, CA 92705-5814
(877) 896-7350
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024168309
VA
Other
Enumeration date
09/24/2009
Last updated
04/24/2019
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