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NPI Code Detail

MEDICARE: ELIZABETH ANN NYGREN R.N.

MEDICARE: ELIZABETH ANN NYGREN R.N.
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
1163W00000XRegistered Nurse128839-30WI

General Provider Information

NPI Number : 1720155963
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ANN NYGREN R.N.
Provider Business Mailing Address
First Line : 615 W MORELAND BLVD
Second Line :
City : WAUKESHA
State : WI
Zip : 53188-2462
Country : US
Telephone Number : 262-896-8430
Fax Number : 262-896-8387
Provider Business Practice Location Address
First Line : 615 W MORELAND BLVD
Second Line :
City : WAUKESHA
State : WI
Zip : 53188-2462
Country : US
Telephone Number : 262-896-8430
Fax Number : 262-896-8387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 07/08/2007

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Directions to “ ELIZABETH ANN NYGREN R.N.” Practice Location

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