Provider Demographics
NPI:1942956487
Name:MOUNIR, ELIZABETH RACHAEL (RN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:RACHAEL
Last Name:MOUNIR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:RACHAEL
Other - Last Name:MAATTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1437 N JEFFERSON ST APT 5
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-2995
Mailing Address - Country:US
Mailing Address - Phone:715-563-6247
Mailing Address - Fax:
Practice Address - Street 1:1437 N JEFFERSON ST APT 5
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2995
Practice Address - Country:US
Practice Address - Phone:715-563-6247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI261681163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health