Provider Demographics
NPI:1730376484
Name:EMERSON, ELIZABETH ANNE (DC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANNE
Last Name:EMERSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:8499 STATE HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:FISH CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:54212-9419
Mailing Address - Country:US
Mailing Address - Phone:920-868-9280
Mailing Address - Fax:
Practice Address - Street 1:8499 STATE HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:FISH CREEK
Practice Address - State:WI
Practice Address - Zip Code:54212-9419
Practice Address - Country:US
Practice Address - Phone:920-868-9280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4344111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor