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Individual

ELIZABETH HUMPHRIES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN,CNM

Contact information

Practice address
2911 MARINA DR, MIDDLETON, WI 53562-1823
(608) 770-2730
Mailing address
2911 MARINA DR, MIDDLETON, WI 53562-1823
(608) 770-2730

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
137774-030
WI
163WH0200X
Home Health Registered Nurse
Primary
137774-032
WI

Other

Enumeration date
11/30/2010
Last updated
03/07/2015
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