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Individual

ELIZABETH KOCOUREK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1601 SHOTO RD, TWO RIVERS, WI 54241-9184
(920) 684-3871
Mailing address
1601 SHOTO RD, TWO RIVERS, WI 54241-9184
(920) 684-3871

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
14540-031
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38239900
WI
Enumeration date
05/20/2008
Last updated
05/20/2008
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