| Doctor Name: | BETH A HOUSELOG |
| NPI Number: | 1194738559 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | |
| Business Practice Address: | 4315 S Lake Dr Cudahy, WI - 531101241 |
| Business Phone Number: | 4142944622 |
| Business Fax Number: | |
| Mailing Address: | 4315 S Lake Dr, CUDAHY |
| State: | WI |
| Postal Code: | 531101241 |
| Phone Number: | 4142944622 |
| Fax Number: | |
| NPI Enumeration Date: | 08/15/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |