Provider Demographics
NPI:1043872468
Name:LENKIN, ELISSA (CD(DONA), CLC)
Entity Type:Individual
Prefix:
First Name:ELISSA
Middle Name:
Last Name:LENKIN
Suffix:
Gender:F
Credentials:CD(DONA), CLC
Other - Prefix:
Other - First Name:ELISSA
Other - Middle Name:
Other - Last Name:LENKIN WEBER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CD(DONA), CLC
Mailing Address - Street 1:5844 N KENT AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH BAY
Mailing Address - State:WI
Mailing Address - Zip Code:53217-4612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5844 N KENT AVE
Practice Address - Street 2:
Practice Address - City:WHITEFISH BAY
Practice Address - State:WI
Practice Address - Zip Code:53217-4612
Practice Address - Country:US
Practice Address - Phone:414-828-9203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula