Healthcare Provider Details

I. General information

NPI: 1932046992
Provider Name (Legal Business Name): ELINOR ROSE WERNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E FAIRMOUNT AVE
WHITEFISH BAY WI
53217-6011
US

IV. Provider business mailing address

1573 CHEYENNE AVE UNIT D
GRAFTON WI
53024-9307
US

V. Phone/Fax

Practice location:
  • Phone: 414-963-3901
  • Fax:
Mailing address:
  • Phone: 262-332-1499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number512927
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: