Provider Demographics
NPI:1891933354
Name:ELSAESSER, ELIZABETH ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:ELSAESSER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:MUELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:130 WARREN ST STE 130
Mailing Address - Street 2:
Mailing Address - City:BEAVER DAM
Mailing Address - State:WI
Mailing Address - Zip Code:53916-3041
Mailing Address - Country:US
Mailing Address - Phone:920-885-5225
Mailing Address - Fax:920-356-6419
Practice Address - Street 1:130 WARREN ST STE 130
Practice Address - Street 2:
Practice Address - City:BEAVER DAM
Practice Address - State:WI
Practice Address - Zip Code:53916-3041
Practice Address - Country:US
Practice Address - Phone:920-885-5225
Practice Address - Fax:920-356-6419
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant