Individual
ELIZABETH J HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, RN, FNP-BC,APNP
Contact information
Practice address
8400 WASHINGTON AVE, MOUNT PLEASANT, WI 53406-3735
(262) 884-4000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6135
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100042723
—
WI
05
—
1619374592
—
WI
Enumeration date
11/20/2014
Last updated
01/04/2024
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