Provider Demographics
NPI:1932310257
Name:MORIN, ELLEN MARIE (NP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:MARIE
Last Name:MORIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17931 RED FEATHER LAKES RD
Mailing Address - Street 2:
Mailing Address - City:RED FEATHER LAKES
Mailing Address - State:CO
Mailing Address - Zip Code:80545-9410
Mailing Address - Country:US
Mailing Address - Phone:970-224-1222
Mailing Address - Fax:
Practice Address - Street 1:1525 BLUE SPRUCE DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2004
Practice Address - Country:US
Practice Address - Phone:970-498-6885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO121076363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health