Individual
ELIZABETH JODIE PERKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1515 PARK AVE, COLUMBUS, WI 53925-1618
(920) 623-2200
Mailing address
1515 PARK AVE, COLUMBUS, WI 53925-2402
(920) 623-1200
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
222140
WI
363L00000X
Nurse Practitioner
Primary
12109-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
222140
RN LISCENSE
WI
Enumeration date
03/01/2022
Last updated
09/20/2022
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