Individual
TAMMY S ELGERSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
710 RIVERSIDE DR, WAUPACA, WI 54981-1941
(715) 256-3000
(715) 256-3079
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 830-5900
(715) 256-3079
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2211-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710167671
—
WI
Enumeration date
11/08/2007
Last updated
05/20/2021
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