Provider Demographics
NPI:1861493009
Name:KRESSIN, ELIZABETH C (DC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:C
Last Name:KRESSIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 800
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-6004
Mailing Address - Country:US
Mailing Address - Phone:712-580-5090
Mailing Address - Fax:712-580-5091
Practice Address - Street 1:1025 5TH AVE SE
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-6004
Practice Address - Country:US
Practice Address - Phone:712-580-5090
Practice Address - Fax:712-580-5091
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA5252111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0247627Medicaid
IAT65208Medicare UPIN
IAIB3008Medicare UPIN
IA0247627Medicaid