MEDICARE: ELIZABETH W CHILTON ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	CP000243	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	39751	OTHER	IA	WELLMARK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	4994586	OTHER	SD	WELLMARK

General Provider Information

NPI Number	:	1982637310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH W CHILTON ARNP

Provider Business Mailing Address
First Line	:	1021 NEBRASKA ST
Second Line	:	P.O. BOX 5410
City	:	SIOUX CITY
State	:	IA
Zip	:	51105-1436
Country	:	US
Telephone Number	:	712-252-2477
Fax Number	:	712-252-5516

Provider Business Practice Location Address
First Line	:	1021 NEBRASKA ST
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-5410
Country	:	US
Telephone Number	:	712-252-2477
Fax Number	:	712-252-5516

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	09/29/2011

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