Provider Demographics
NPI:1275140261
Name:BLETSCHER, ERICA LEA (APRN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LEA
Last Name:BLETSCHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 PIONEER ST
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:KS
Mailing Address - Zip Code:66538-1673
Mailing Address - Country:US
Mailing Address - Phone:785-766-5370
Mailing Address - Fax:
Practice Address - Street 1:14TH AND OREGON STREET
Practice Address - Street 2:
Practice Address - City:SABETHA
Practice Address - State:KS
Practice Address - Zip Code:66534
Practice Address - Country:US
Practice Address - Phone:785-284-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-79709-112363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner