Elizabeth Kay Anderson, RN
Individual provider Active NPI Registered Nurse · Frederic, WI
NPI 1013518786 · NPPES record last updated Nov 23, 2020
Key facts
- NPI
- 1013518786
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 1179150 (MN)
- Practice address
- 105 Birch St E
Frederic, WI 54837-8985 - Phone
- (715) 553-3158
- NPI assigned
- Nov 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1179150 | MN | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1179150 | MN | Yes |
Addresses
Primary practice location
105 Birch St E
Frederic, WI 54837-8985
Mailing address
PO Box 487
Frederic, WI 54837-0487
Phone (715) 553-3158
Other providers in Frederic, WI
All providers in Frederic, WI · Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.