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Stephanie Annakay Mcelligott

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669

PECOS Enrollment

This provider is enrolled in PECOS as STEPHANIE MCELLIGOTT.

Based on the most recent information from CMS, provider Stephanie Annakay Mcelligott is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:26 AM.

Profile Details

Provider ID
1114214210
Provider Type
Individual
Full Name
Mcelligott, Stephanie Annakay
Title
Mrs.
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
7/9/2011
Last Updated
2/27/2014

Contact Information

Practice Location

2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669

(262) 224-1396

Unlisted Fax

Mailing Location

335 E Gate Dr, Hartford, WI 53027-8318

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 2788-023 Wisconsin
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 2788-023 Wisconsin

Stephanie Annakay Mcelligott

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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