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Individual

MRS. ELIZABETH L THEPPANYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
2906 S 20TH ST, MILWAUKEE, WI 53215-3732
(141) 467-2135
(414) 645-0232
Mailing address
PO BOX 778789, CHICAGO, IL 60677-8789
(414) 672-1353

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
172556-30
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11255-33
WI

Other

Enumeration date
04/12/2021
Last updated
11/29/2023
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