Individual
ELIZABETH MARY TIMM SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8600 SHERIDAN RD, SUITE 600, KENOSHA, WI 53143-6506
(262) 605-6767
Mailing address
8600 SHERIDAN RD, SUITE 600, KENOSHA, WI 53143-6506
(262) 605-6767
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6738-33
WI
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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