Healthcare Provider Details

I. General information

NPI: 1871419234
Provider Name (Legal Business Name): ERIKA LEICHTNAM PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1506 S ONEIDA ST
APPLETON WI
54915-1305
US

IV. Provider business mailing address

304 FORT DR
NEENAH WI
54956-4559
US

V. Phone/Fax

Practice location:
  • Phone: 920-738-2282
  • Fax:
Mailing address:
  • Phone: 920-738-2282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19172-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: