Healthcare Provider Details

I. General information

NPI: 1053113324
Provider Name (Legal Business Name): ELISE BATTLE MSN, CPNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 W WISCONSIN AVE
MILWAUKEE WI
53226-4874
US

IV. Provider business mailing address

2168 N 64TH ST
WAUWATOSA WI
53213-2028
US

V. Phone/Fax

Practice location:
  • Phone: 414-337-7140
  • Fax:
Mailing address:
  • Phone: 630-770-4773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number16620-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: