Basic Information
| Provider Information | |||||||||
| NPI: | 1497863070 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VANCURA | ||||||||
| FirstName: | ELLEN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1217 8TH ST N | ||||||||
| Address2: | |||||||||
| City: | NEW ULM | ||||||||
| State: | MN | ||||||||
| PostalCode: | 560731552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5072175000 | ||||||||
| FaxNumber: | 5072175033 | ||||||||
| Practice Location | |||||||||
| Address1: | 1217 8TH ST N | ||||||||
| Address2: | |||||||||
| City: | NEW ULM | ||||||||
| State: | MN | ||||||||
| PostalCode: | 560731552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5072175000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2006 | ||||||||
| LastUpdateDate: | 03/09/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 23672 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.