Provider Demographics
NPI:1467224691
Name:CONNORS, ELIZABETH LAURA (MSN, CNM)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LAURA
Last Name:CONNORS
Suffix:
Gender:F
Credentials:MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 N GRAND AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-4984
Mailing Address - Country:US
Mailing Address - Phone:414-485-5068
Mailing Address - Fax:262-357-9429
Practice Address - Street 1:403 N GRAND AVE STE 101
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-4984
Practice Address - Country:US
Practice Address - Phone:414-485-5068
Practice Address - Fax:262-357-9429
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
WI150013-32176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula