Healthcare Provider Details

I. General information

NPI: 1972909729
Provider Name (Legal Business Name): ERICKA STURSA-PATENAUDE APRN-RX, FNP, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 09/12/2025
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 MALABEY ST
KAILUA HI
96734-5020
US

IV. Provider business mailing address

1516 MALABEY ST
KAILUA HI
96734-5020
US

V. Phone/Fax

Practice location:
  • Phone: 210-251-7452
  • Fax:
Mailing address:
  • Phone: 210-251-7452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number026.0079136
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-4511-0
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number867436
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL58165
License Number StateCO
# 5
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN-108915
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: