Individual
ELISSA MARIE LARKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN, CNM
Contact information
Practice address
2311 S BONNIE BROOK LN, WAUKEGAN, IL 60087-3721
(831) 264-3771
(888) 959-0674
Mailing address
2311 S BONNIE BROOK LN, WAUKEGAN, IL 60087-3721
(831) 264-3771
(888) 959-0674
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041421123
IL
367A00000X
Advanced Practice Midwife
148897-32
WI
367A00000X
Advanced Practice Midwife
Primary
209011894
IL
Other
Enumeration date
07/23/2014
Last updated
09/27/2014
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