Provider Demographics
NPI:1588632947
Name:YAHR, ELIZABETH S (PA-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:S
Last Name:YAHR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 DELAFIELD ST
Mailing Address - Street 2:STE 209
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-3403
Mailing Address - Country:US
Mailing Address - Phone:262-542-0444
Mailing Address - Fax:262-542-8214
Practice Address - Street 1:1111 DELAFIELD ST
Practice Address - Street 2:STE 209
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-3403
Practice Address - Country:US
Practice Address - Phone:262-542-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1882-023363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI683750717Medicare PIN
WIQ49699Medicare UPIN
WI0059Medicare ID - Type UnspecifiedMEDICARE GROUP 73844