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General NPI Number Information
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NPI Number | 1972487817
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Entity Type | Individual
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Provider Name | EMILY KENDRA BERQUIST APNP
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Gender | Female
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1969 W HART RD
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City | BELOIT
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State | WI
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Zip | 53511-2230
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Country | US
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Telephone | 608-364-5011
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Fax |
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Provider Business Mailing Address
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Address Line | 11901 N BRYANT RD
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City | FORT ATKINSON
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State | WI
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Zip | 53538-9216
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Country | US
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Telephone | 920-691-2106
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1718533
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License Number State | WI
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