NPI 1003573841
Elissa M Derksen, LPN
Practice location
- Address
- 2422 N Grandview Blvd, Waukesha, WI 53188-6105
- Phone
- (262) 549-6600
- Mailing address
- 407 Hartwood Ln, Hartland, WI 53029-2409
Registered specialties
Licensed Practical Nurse
Primary
Registry record
- NPI
- 1003573841
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 28 Nov 2021
- Record last updated
- 28 Nov 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.