Healthcare Provider Details

I. General information

NPI: 1619478302
Provider Name (Legal Business Name): ELIZABETH A KRIPPINGER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH A VEON OTR/L

II. Dates (important events)

Enumeration Date: 02/27/2018
Last Update Date: 01/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10222 74TH ST STE 211
KENOSHA WI
53142-6810
US

IV. Provider business mailing address

600 52ND ST STE 240
KENOSHA WI
53140-3423
US

V. Phone/Fax

Practice location:
  • Phone: 262-925-5020
  • Fax: 262-925-5021
Mailing address:
  • Phone: 262-925-5004
  • Fax: 262-925-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6246
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: