Provider Demographics
NPI:1407239387
Name:GILGUR, ELINA Y (DNP)
Entity Type:Individual
Prefix:DR
First Name:ELINA
Middle Name:Y
Last Name:GILGUR
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
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Mailing Address - Street 1:12500 W BLUEMOUND RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ELM GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53122-2600
Mailing Address - Country:US
Mailing Address - Phone:262-787-2114
Mailing Address - Fax:262-787-2140
Practice Address - Street 1:12500 W BLUEMOUND RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2600
Practice Address - Country:US
Practice Address - Phone:262-787-2114
Practice Address - Fax:262-787-2140
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI6422363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1407239387Medicaid
WIK400362091Medicare PIN