Healthcare Provider Details

I. General information

NPI: 1962471839
Provider Name (Legal Business Name): ELIZABETH ANN GLISPER R.N./ BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6087 N 35TH ST
MILWAUKEE WI
53209-3601
US

IV. Provider business mailing address

6087 N 35TH ST
MILWAUKEE WI
53209-3601
US

V. Phone/Fax

Practice location:
  • Phone: 414-466-1045
  • Fax:
Mailing address:
  • Phone: 414-466-1045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number81588
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number81588
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: