Healthcare Provider Details

I. General information

NPI: 1619987831
Provider Name (Legal Business Name): ELIZABETH S CAMERON APSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 N 3RD AVE SUITE A
WAUSAU WI
54401-2913
US

IV. Provider business mailing address

6325 RAINBOW DR
MERRILL WI
54452-7704
US

V. Phone/Fax

Practice location:
  • Phone: 715-848-3031
  • Fax: 715-848-5008
Mailing address:
  • Phone: 715-848-3031
  • Fax: 715-848-5008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number575-121
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number56649-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: