Doctor Name: | MS. MARY ELLEN EHMAN |
NPI Number: | 1255404265 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 8167 |
Business Practice Address: | 1405 Teresa Drive Morro Bay, CA - 93442 |
Business Phone Number: | 8057722237 |
Business Fax Number: | 8057722536 |
Mailing Address: | 355 Las Vegas, MORRO BAY |
State: | CA |
Postal Code: | 93442 |
Phone Number: | 8057727100 |
Fax Number: | 8057727776 |
NPI Enumeration Date: | 11/16/2006 |
NPI Last Update Date: | 03/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 8167 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |