Smith, Elaine M

Smith, Elaine M is an individual health care provider with primary practice located at 301 Bay Park Sq , Green Bay WI 54304-5104. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Smith, Elaine M can be contacted via phone (920) 592-9475.

Contact Information

Primary practice address
301 Bay Park Sq Green Bay WI 54304-5104
Phone: (920) 592-9475
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1317 Wisconsin

Profile Details

NPI number 1285684662
LBN Legal business name Smith, Elaine M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Jul 8th, 2007 - about 18 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 1285684662 NPPES
Wisconsin Other 1317-023 LICENSE
Wisconsin MEDICAID 39842400 LICENSE

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