Ellen L Beary, R.E.
Individual provider Active NPI Specialist · Waukesha, WI
NPI 1043069164 · NPPES record last updated May 13, 2024
Key facts
- NPI
- 1043069164
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 1112-84 (WI)
- Practice address
- 1507 E Sunset Dr Ste 140
Waukesha, WI 53189-8213 - Phone
- (414) 303-0660
- NPI assigned
- May 13, 2024
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1112-84 | WI | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Electrology Essentials and Jacqui Ohhs Salon | Specialist | Current |
Accepting new patients |
Locations
1507 E Sunset Dr
Ste 140
Waukesha, WI 53189
Phone (414) 303-0660
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1112-84 | WI | Yes |
Addresses
Primary practice location
1507 E Sunset Dr Ste 140
Waukesha, WI 53189-8213
Mailing address
1507 E Sunset Dr Ste 140
Waukesha, WI 53189-8213
Phone (414) 303-0660
Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2024. 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.