Healthcare Provider Details

I. General information

NPI: 1487174157
Provider Name (Legal Business Name): LISA ANNE ERICKSON APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA ANNE RATTEI

II. Dates (important events)

Enumeration Date: 06/23/2017
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 US HIGHWAY 8 W
TURTLE LAKE WI
54889-4411
US

IV. Provider business mailing address

265 GRIFFIN ST E
AMERY WI
54001-1439
US

V. Phone/Fax

Practice location:
  • Phone: 715-822-7500
  • Fax: 715-822-7221
Mailing address:
  • Phone: 715-268-8000
  • Fax: 715-268-0381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7897-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: