Provider Demographics
NPI:1245795186
Name:KILKENNY, ERIN TOIREASA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:TOIREASA
Last Name:KILKENNY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 BURR OAK CT
Mailing Address - Street 2:
Mailing Address - City:DELAVAN
Mailing Address - State:WI
Mailing Address - Zip Code:53115-1229
Mailing Address - Country:US
Mailing Address - Phone:262-812-7785
Mailing Address - Fax:
Practice Address - Street 1:711 BURR OAK CT
Practice Address - Street 2:
Practice Address - City:DELAVAN
Practice Address - State:WI
Practice Address - Zip Code:53115-1229
Practice Address - Country:US
Practice Address - Phone:262-812-7785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI322839164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse