Elmendorf, Nichole M
Elmendorf, Nichole M is an individual health care provider with primary practice located at 1125 N 13Th St , Sheboygan WI 53081-3281. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Elmendorf, Nichole M can be contacted via phone (920) 803-1617.Contact Information
Primary practice address
1125 N 13Th St
Sheboygan WI 53081-3281
Phone: (920) 803-1617
Fax: (920) 803-1622
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | 2461 | Wisconsin |
Profile Details
| NPI number | 1255519443 |
|---|---|
| LBN Legal business name | Elmendorf, Nichole M |
| Credentials | Registered Occupational Therapist (OTR) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 10th, 2008 |
| Last updated | Oct 10th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255519443 | NPPES |
| Wisconsin | MEDICAID | 40806400 | |
| Wisconsin | MEDICAID | 41813000 |
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