Healthcare Provider Details

I. General information

NPI: 1467364414
Provider Name (Legal Business Name): ARIEL NADAENE ECKERT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 53RD AVE
KENOSHA WI
53142-3014
US

IV. Provider business mailing address

6320 53RD AVE
KENOSHA WI
53142-3014
US

V. Phone/Fax

Practice location:
  • Phone: 262-237-4942
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number241175-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: