Healthcare Provider Details

I. General information

NPI: 1790103471
Provider Name (Legal Business Name): COURTNEY ELM ANDERSON M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY MERYL LOMKER ELM M.D

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1836 SOUTH AVE
LA CROSSE WI
54601-5429
US

IV. Provider business mailing address

1836 SOUTH AVE
LA CROSSE WI
54601-5429
US

V. Phone/Fax

Practice location:
  • Phone: 608-782-7300
  • Fax:
Mailing address:
  • Phone: 608-782-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number67041-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number61515
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: