Provider Demographics
NPI:1639661101
Name:YERKE, NICHOLE KATHERINE (RN)
Entity type:Individual
Prefix:MRS
First Name:NICHOLE
Middle Name:KATHERINE
Last Name:YERKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12021 52ND ST S
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-8574
Mailing Address - Country:US
Mailing Address - Phone:715-570-2552
Mailing Address - Fax:
Practice Address - Street 1:12021 52ND ST S
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-8574
Practice Address - Country:US
Practice Address - Phone:715-570-2552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI240389163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse