Basic Information
| Provider Information | |||||||||
| NPI: | 1881928547 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCOOL | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | W331N5360 CHERRY CT | ||||||||
| Address2: | |||||||||
| City: | NASHOTAH | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530589762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4148400539 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3100 SUPERIOR AVE | ||||||||
| Address2: | ST. NICHOLAS HOSPITAL | ||||||||
| City: | SHEBOYGAN | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530811948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9204964700 | ||||||||
| FaxNumber: | 9204964705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2009 | ||||||||
| LastUpdateDate: | 11/21/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 3862-33 | WI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.