Provider Demographics
NPI:1073752507
Name:LOKER, ELLEN M (RN)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:M
Last Name:LOKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4083 WESTVIEW LN
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-6901
Mailing Address - Country:US
Mailing Address - Phone:920-235-7251
Mailing Address - Fax:
Practice Address - Street 1:4083 WESTVIEW LN
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-6901
Practice Address - Country:US
Practice Address - Phone:920-235-7251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI125687163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse