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General NPI Number Information
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NPI Number | 1093429151
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Entity Type | Individual
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Provider Name | ELIZABETH SUSAN REID APNP
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Gender | Female
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | W801 ROME OAK HILL RD
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City | PALMYRA
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State | WI
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Zip | 53156-9729
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Country | US
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Telephone | 262-875-4892
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Fax | 866-817-3838
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Provider Business Mailing Address
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Address Line | PO BOX 438
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City | SULLIVAN
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State | WI
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Zip | 53178-0438
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Country | US
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Telephone | 262-875-4892
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Fax | 866-817-3838
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 13462-33
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License Number State | WI
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