Basic Information
| Provider Information | |||||||||
| NPI: | 1891277703 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAURER | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | JANE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16 LAKE RD | ||||||||
| Address2: | |||||||||
| City: | MENASHA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 549523416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9206062985 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1818 N MEADE ST | ||||||||
| Address2: | |||||||||
| City: | APPLETON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 549113454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9207314101 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2018 | ||||||||
| LastUpdateDate: | 09/06/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WX0003X | 223849 | WI | Y | Nursing Service Providers | Registered Nurse | Obstetric, Inpatient |
No ID Information.