Provider Demographics
NPI:1346022845
Name:CONSIGNY, ELLIOT JAMES (RN)
Entity Type:Individual
Prefix:
First Name:ELLIOT
Middle Name:JAMES
Last Name:CONSIGNY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOREB
Mailing Address - State:WI
Mailing Address - Zip Code:53572-1737
Mailing Address - Country:US
Mailing Address - Phone:608-772-5087
Mailing Address - Fax:
Practice Address - Street 1:403 N 4TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOREB
Practice Address - State:WI
Practice Address - Zip Code:53572-1737
Practice Address - Country:US
Practice Address - Phone:608-772-5087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI219544163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse