Provider Demographics
NPI:1154650968
Name:NOLKER, ELIZABETH EILEEN (CNM)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:EILEEN
Last Name:NOLKER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:EILEEN
Other - Last Name:DROEGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 HEALTHCARE DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62246-1161
Mailing Address - Country:US
Mailing Address - Phone:618-664-9830
Mailing Address - Fax:618-664-9820
Practice Address - Street 1:1520 S 4TH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:IL
Practice Address - Zip Code:62246-2618
Practice Address - Country:US
Practice Address - Phone:618-664-1442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277000229163WW0101X
IL209007926367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory