Ellenson, Mattie
Ellenson, Mattie is an sole proprietor health care provider with primary practice located at 560 W Fir Ave , Fergus Falls MN 56537-1364. She recently has only one registered license in Agencies / Public Health or Welfare, which is considered as her primary health care specialty. Ellenson, Mattie can be contacted via phone (218) 998-8320.Contact Information
Primary practice address
560 W Fir Ave
Fergus Falls MN 56537-1364
Phone: (218) 998-8320
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Public Health or Welfare | 251K00000X | 2149257 | Minnesota |
Profile Details
| NPI number | 1316579337 |
|---|---|
| LBN Legal business name | Ellenson, Mattie |
| Credentials | RN, BSN, MPH |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 7th, 2020 |
| Last updated | Feb 24th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316579337 | NPPES |
| Minnesota | MEDICAID | 518853900 |
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