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Contact Information

ELIZABETH J TLACHAC
2845 GREENBRIER RD
GREEN BAY, WI54311-6519
 Phone: 920-490-9046
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Obstetric, Inpatient

163WX0003X
Indicates primary specialty

NPI Profile & details for ELIZABETH J TLACHAC · (Female)

NPI Number 1891277703
Status Active
Credentials
Entity Individual
Enumeration date 09/06/2018
Last updated 04/19/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 13119
  • WI License # 223849
  • WI Medicaid 100228350
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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