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Individual

DR. HEATHER ELLSWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
640 JACKSON STREET, REGIONS HOSPITAL, ST PAUL, MN 55101
(651) 254-3456
Mailing address
640 JACKSON STREET, REGIONS HOSPITAL, ST PAUL, MN 55101
(651) 254-3456

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
52983
MN

Other

Enumeration date
04/08/2008
Last updated
02/15/2011
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