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General NPI Number Information
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NPI Number | 1053965822
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Entity Type | Individual
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Provider Name | ELIZABETH LEE HORWATH MSN, RN, AGACNP, FNP
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Gender | Female
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 240 MAPLE ST
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City | WOODRUFF
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State | WI
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Zip | 54568-9190
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Country | US
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Telephone | 715-356-8140
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4
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City | CONOVER
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State | WI
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Zip | 54519-0004
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Country | US
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Telephone | 715-617-5255
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 9149-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9149-33
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License Number State | WI
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