MEDICARE: ELIZABETH RACHAEL MOUNIR RN

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
1	163WH0200X	Home Health Registered Nurse	261681	WI

General Provider Information

NPI Number	:	1942956487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH RACHAEL MOUNIR RN

Provider Business Mailing Address
First Line	:	1437 N JEFFERSON ST APT 5
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-2995
Country	:	US
Telephone Number	:	715-563-6247
Fax Number	:

Provider Business Practice Location Address
First Line	:	1437 N JEFFERSON ST APT 5
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-2995
Country	:	US
Telephone Number	:	715-563-6247
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2022
Last Update Date	:	02/23/2022

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