Elizabeth Henderson Cernohous, NP

Individual provider Active NPI Nurse Practitioner · Ladysmith, WI

NPI 1467569715 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1467569715
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
2717 (WI)
Practice address
906 College Ave West
Ladysmith, WI 54848
Phone
(715) 532-2345
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2717WIMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2717 WI Yes

Addresses

Primary practice location

906 College Ave West
Ladysmith, WI 54848

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Other identifiers

IdentifierTypeStateIssuer
43854500MedicaidWI

Other providers in Ladysmith, WI

All providers in Ladysmith, WI · Nurse Practitioner in Wisconsin

Sources for this page

Verify at the official NPI Registry.