Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | CPO04219 | DE |
N | 222Z00000X | Podiatrist | CPO04219 | DE |
Y | 224P00000X | Prosthetist | CPO04219 | DE |
NPI | 1215493903 |
---|---|
Provider Name | Elizabeth Bianchi Knod |
First Address | Kenosha, WI 53144-1771 |
Second Address | Kenosha, WI 53144-1771 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2019 |
Last Update Date | 27/02/2019 |