Wennerstrom, Elizabeth Ann
Wennerstrom, Elizabeth Ann is an individual health care provider with primary practice located at 13460 N 94Th Dr Ste J1 , Peoria AZ 85381-4264. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Wennerstrom, Elizabeth Ann can be contacted via phone (623) 876-8816.Contact Information
Primary practice address
13460 N 94Th Dr Ste J1
Peoria AZ 85381-4264
Phone: (623) 876-8816
Fax: (623) 298-0168
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 7262 | Arizona |
Profile Details
| NPI number | 1114498029 |
|---|---|
| LBN Legal business name | Wennerstrom, Elizabeth Ann |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 17th, 2018 |
| Last updated | Jan 18th, 2024 - 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 | 1114498029 | NPPES |
| Arizona | MEDICAID | 125100 |
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