Individual
ELISE MARIE BERES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY, SUITE 414, MILWAUKEE, WI 53215-3677
(262) 827-3630
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3405-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100041174
—
WI
Enumeration date
09/16/2014
Last updated
11/30/2023
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