MS. ELIZABETH KATHLEEN KELLEY LPN/RCS NPI 1194914499

NPI Information

NPI: 1194914499
Provider Name: MS. ELIZABETH KATHLEEN KELLEY, LPN/RCS
Classification: Licensed Practical Nurse - 164W00000X
Entity Type: Individual
Address:
W4764 HIDDEN PINE LN
SHAWANO, WI
ZIP 54166
Phone: (920) 858-2682
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MS. Elizabeth Kathleen Kelley, LPN/RCS is a licensed practical nurse in Shawano, WI. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. MS. Elizabeth Kathleen Kelley, LPN/RCS NPI is 1194914499. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

W4764 HIDDEN PINE LN
SHAWANO, WI
ZIP 54166-650
Phone: (920) 858-2682
Fax: (715) 745-2957

The enumeration date for this NPI number is 10/23/2007 and was last updated on 10/23/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	164W00000X	Licensed Practical Nurse		27691-031	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	38275700	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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