Elizabeth Abegglen, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Green Bay, WI
NPI 1124821848 · NPPES record last updated Jul 2, 2025
Key facts
- NPI
- 1124821848
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 3021 Voyager Dr
Green Bay, WI 54311-8303 - Phone
- (920) 431-1810
- NPI assigned
- Mar 28, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250702001068 | WI | Order and Referring Only - Family Practice |
1850804832 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | WI | Yes |
Addresses
Primary practice location
3021 Voyager Dr
Green Bay, WI 54311-8303
Mailing address
PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 431-1810
Other providers in Green Bay, WI
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- Semhal Abbay
- Kamal Kant Singh Abbi
- Nicole Abdo
- Eric Abdul
- Caleb Joseph Abfall
- Amber M Abraham
- Clayton Edward Abts
- Jade Catherine Abts
- Tianna Abts
All providers in Green Bay, WI · Student in an Organized Health Care Education/Training Program in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.