Individual
ELISA TRIMARCO PREBBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1432 W FOREST HOME AVE, MILWAUKEE, WI 53204-3228
(414) 567-5400
Mailing address
1432 W FOREST HOME AVE, MILWAUKEE, WI 53204-3228
(414) 567-5400
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
77260
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942763024
—
WI
Enumeration date
04/07/2019
Last updated
08/30/2022
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