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NPI Code Detail

MEDICARE: ELIZABETH ANN DOORNINK APRN

MEDICARE: ELIZABETH ANN DOORNINK APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LN0000XNeonatal Nurse Practitioner1603633WI
2363LN0000XNeonatal Nurse Practitioner209032792IL

General Provider Information

NPI Number : 1427878230
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ANN DOORNINK APRN
Provider Business Mailing Address
First Line : 1523 N VIOLA ST
Second Line :
City : APPLETON
State : WI
Zip : 54911-3851
Country : US
Telephone Number : 920-202-2662
Fax Number :
Provider Business Practice Location Address
First Line : 835 S VAN BUREN ST
Second Line :
City : GREEN BAY
State : WI
Zip : 54301-3526
Country : US
Telephone Number : 920-433-0111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2024
Last Update Date : 12/03/2025

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