Provider Demographics
NPI:1184837676
Name:ELLIOTT, BRIDGET P (AUD)
Entity type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:P
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 S. 6TH STREET
Mailing Address - Street 2:AUDIOLOGY DEPARTMENT
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154
Mailing Address - Country:US
Mailing Address - Phone:414-346-8167
Mailing Address - Fax:414-346-8010
Practice Address - Street 1:7901 S. 6TH STREET
Practice Address - Street 2:AUDIOLOGY DEPARTMENT
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154
Practice Address - Country:US
Practice Address - Phone:414-346-8167
Practice Address - Fax:414-346-8010
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI312-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1184837676Medicaid
Q26820Medicare UPIN
WI00010-86395Medicare PIN