Individual
ELLEN N CANOPY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3004 GOLF RD, EAU CLAIRE, WI 54701
(715) 514-2827
Mailing address
3004 GOLF RD, EAU CLAIRE, WI 54701-8793
(715) 514-2827
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2730-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952693491
—
WI
Enumeration date
05/03/2011
Last updated
03/19/2019
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