Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 143430 | WI |
Y | 363L00000X | Nurse Practitioner | 3182 | WI |
NPI | 1013107069 |
---|---|
Provider Name | Erika A Fehrenbach Prell |
First Address | Middleton, WI 53562-2016 |
Second Address | Madison, WI 53792-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2007 |
Last Update Date | 26/02/2009 |