Provider Demographics
NPI:1033886239
Name:BREESER, ERIKA (NP-C)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:BREESER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:KENDZIERSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:N52W35379 W LAKE DR
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-3336
Mailing Address - Country:US
Mailing Address - Phone:262-490-4807
Mailing Address - Fax:
Practice Address - Street 1:36500 AURORA DR
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:WI
Practice Address - Zip Code:53066-4899
Practice Address - Country:US
Practice Address - Phone:262-434-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10964-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily