Healthcare Provider Details

I. General information

NPI: 1033800370
Provider Name (Legal Business Name): ARIKA E HERNANDEZ APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11516 N PORT WASHINGTON RD STE 208
MEQUON WI
53092-3441
US

IV. Provider business mailing address

11516 N PORT WASHINGTON RD STE 208
MEQUON WI
53092-3441
US

V. Phone/Fax

Practice location:
  • Phone: 920-242-4505
  • Fax: 262-228-1620
Mailing address:
  • Phone: 920-242-4505
  • Fax: 262-228-1620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number13974-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number13974-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: