Provider Demographics
NPI:1689086977
Name:DEUSER, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:DEUSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 GRAND AVE APT B
Mailing Address - Street 2:
Mailing Address - City:THIENSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53092-1260
Mailing Address - Country:US
Mailing Address - Phone:608-219-3684
Mailing Address - Fax:
Practice Address - Street 1:116 GRAND AVE APT B
Practice Address - Street 2:
Practice Address - City:THIENSVILLE
Practice Address - State:WI
Practice Address - Zip Code:53092-1260
Practice Address - Country:US
Practice Address - Phone:608-219-3684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI161299-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse