Healthcare Provider Details
I. General information
NPI: 1912454687
Provider Name (Legal Business Name): ERIKA M. KLITZKE NNP-BC, CPNP-BC, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/09/2016
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9000 W WISCONSIN AVE DIVISION OF NEONATOLOGY
MILWAUKEE WI
53226-4874
US
IV. Provider business mailing address
9000 W WISCONSIN AVE DIVISION OF NEONATOLOGY
MILWAUKEE WI
53226-4874
US
V. Phone/Fax
- Phone: 414-266-6820
- Fax: 414-266-6979
- Phone: 414-266-6820
- Fax: 414-266-6979
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LN0005X |
| Taxonomy | Critical Care Neonatal Nurse Practitioner |
| License Number | 7245-33 |
| License Number State | WI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | 7245-33 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: