Provider Demographics
NPI:1518577261
Name:CIULLA, ERICA R (APNP)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:R
Last Name:CIULLA
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54482-8703
Mailing Address - Country:US
Mailing Address - Phone:715-570-4779
Mailing Address - Fax:
Practice Address - Street 1:2720 PLAZA DR STE 2100
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4157
Practice Address - Country:US
Practice Address - Phone:715-847-2475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10232363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner