Provider Demographics
NPI:1558020636
Name:ELGER, JACQUELINE BODIL (FNP-BC, APNP)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:BODIL
Last Name:ELGER
Suffix:
Gender:F
Credentials:FNP-BC, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-2224
Mailing Address - Country:US
Mailing Address - Phone:262-751-6339
Mailing Address - Fax:
Practice Address - Street 1:325 N CORPORATE DR STE 260
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-5828
Practice Address - Country:US
Practice Address - Phone:262-787-2980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11398363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily