Provider Demographics
NPI:1609412071
Name:PATZER, EMILY (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:PATZER
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 IRIS CT
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53402-1437
Mailing Address - Country:US
Mailing Address - Phone:414-331-4895
Mailing Address - Fax:
Practice Address - Street 1:2505 IRIS CT
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53402-1437
Practice Address - Country:US
Practice Address - Phone:414-331-4895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9686-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily