Individual
ELIZABETH A LULLOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
835 SOUTH VANBUREN STREET, GREEN BAY, WI 54301-3505
(920) 433-0111
Mailing address
835 S. VANBUREN STREET, GREEN BAY, WI 54301-3400
(920) 433-0111
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3193-033
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
3193-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376736660
—
WI
01
—
141374-030
RN
WI
Enumeration date
08/21/2007
Last updated
12/28/2021
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