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General NPI Number Information
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NPI Number | 1386359743
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Entity Type | Individual
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Provider Name | ELIZABETH SMURAWA RN
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Gender | Female
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 1611 SILVERNAIL RD
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City | PEWAUKEE
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State | WI
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Zip | 53072-5519
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Country | US
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Telephone | 414-885-3525
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Fax |
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Provider Business Mailing Address
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Address Line | 15425 HEATHER HILL DR
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City | BROOKFIELD
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State | WI
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Zip | 53005-2603
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Country | US
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Telephone | 262-444-3117
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 1087052-30
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License Number State | WI
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