Provider Demographics
NPI:1477713022
Name:BEYER, ELIZABETH L (APNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:BEYER
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:L
Other - Last Name:KLAMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:GENETICS
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-2979
Mailing Address - Fax:414-266-1616
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:GENETICS
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-2979
Practice Address - Fax:414-266-1616
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21418363LF0000X
WI157832-30163W00000X
WI157832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1477713022Medicaid
CA21418Medicaid
WI1477713022Medicaid