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Individual

LORI ANN ELLERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CST

Contact information

Practice address
5200 HUMMINGBIRD RD, STE 100, WAUSAU, WI 54401-6312
(715) 359-6442
(715) 393-0390
Mailing address
5200 HUMMINGBIRD RD, STE 100, WAUSAU, WI 54401-6312
(715) 359-6442
(715) 393-0390

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
130260
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
130260
CERTIFIED SURGICAL TECHNICIAN
WI
Enumeration date
03/27/2012
Last updated
03/27/2012
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