Healthcare Provider Details

I. General information

NPI: 1578154647
Provider Name (Legal Business Name): LAURA ANN ERNSTER APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2021
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2707 S BUSINESS DR
SHEBOYGAN WI
53081-6515
US

IV. Provider business mailing address

3005 SOUTH 48 TH STREET
MILWAUKEE WI
53219
US

V. Phone/Fax

Practice location:
  • Phone: 920-783-0112
  • Fax: 413-507-6019
Mailing address:
  • Phone: 414-688-4957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10075-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number10075-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: