Provider Demographics
NPI:1568899516
Name:NOESKE, ELIZABETH C
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:C
Last Name:NOESKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4155 N 162ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-1444
Mailing Address - Country:US
Mailing Address - Phone:262-781-5649
Mailing Address - Fax:
Practice Address - Street 1:4155 N 162ND ST
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-1444
Practice Address - Country:US
Practice Address - Phone:262-781-5649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-06
Last Update Date:2013-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10837164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse