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:
Health care specialties
| Specialty | Code | License # | 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 11 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 | 1942477898 | NPPES |
| Wisconsin | MEDICAID | 40360400 |
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