Ellefson, Kimberly

Ellefson, Kimberly is an individual health care provider with primary practice located at 10330 Prairie Ridge Blvd , Pleasant Prairie WI 53158-1947. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Ellefson, Kimberly can be contacted via phone (262) 612-2856.

Contact Information

Primary practice address
10330 Prairie Ridge Blvd Pleasant Prairie WI 53158-1947
Phone: (262) 612-2856
Fax: (262) 612-2893
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 150-019 Wisconsin

Profile Details

NPI number 1942477898
LBN Legal business name Ellefson, Kimberly
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2008
Last updated Mar 5th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942477898 NPPES
Wisconsin MEDICAID 40360400

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