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Individual

JUDITH M ELLINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
530 WI DELLS PKWY S, LAKE DELTON, WI 53940-0390
(608) 254-5400
(608) 253-8585
Mailing address
530 WI DELLS PARKWAY SOUTH, LAKE DELTON, WI 53940-0390
(608) 254-5400
(608) 253-8585

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
49722-030
WI
363L00000X
Nurse Practitioner
Primary
49722
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1720044035
WI
Enumeration date
04/25/2006
Last updated
01/21/2016
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