Provider Demographics
NPI:1346494770
Name:LOPPNOW, ERICA R (APNP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:R
Last Name:LOPPNOW
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:R
Other - Last Name:LUTZE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:PO BOX 735041
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5041
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1222 N 23RD ST
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3171
Practice Address - Country:US
Practice Address - Phone:920-457-6800
Practice Address - Fax:920-459-1423
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3573-33363LX0001X
WI3573363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1346494770Medicaid