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General NPI Number Information
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NPI Number | 1558020636
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Entity Type | Individual
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Provider Name | JACQUELINE BODIL ELGER FNP-BC, APNP
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Gender | Female
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Dates
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Enumeration Date | 12/15/2021
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 325 N CORPORATE DR STE 260
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City | BROOKFIELD
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State | WI
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Zip | 53045-5828
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Country | US
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Telephone | 262-787-2980
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Fax |
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Provider Business Mailing Address
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Address Line | 126 HIGHLAND AVE
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City | HARTLAND
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State | WI
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Zip | 53029-2224
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Country | US
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Telephone | 262-751-6339
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11398
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License Number State | WI
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