Provider Demographics
NPI:1952027344
Name:GASSER, ELIABETH (RN)
Entity Type:Individual
Prefix:
First Name:ELIABETH
Middle Name:
Last Name:GASSER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3872 E VAN NORMAN AVE
Mailing Address - Street 2:
Mailing Address - City:CUDAHY
Mailing Address - State:WI
Mailing Address - Zip Code:53110-1228
Mailing Address - Country:US
Mailing Address - Phone:262-347-8421
Mailing Address - Fax:
Practice Address - Street 1:3872 E VAN NORMAN AVE
Practice Address - Street 2:
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110-1228
Practice Address - Country:US
Practice Address - Phone:262-347-8421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22115630163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse