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Individual

KIRBY ELIZABETH OTTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
100 COUNTY ROAD B, SHAWANO, WI 54166-7072
(920) 731-8900
(920) 225-1414
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7238

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
156249-30
WI
363L00000X
Nurse Practitioner
Primary
5477-33
WI

Other

Enumeration date
08/21/2013
Last updated
02/17/2020
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