Provider Demographics
NPI:1487174157
Name:ERICKSON, LISA ANNE (APNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANNE
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ANNE
Other - Last Name:RATTEI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:265 GRIFFIN ST E
Mailing Address - Street 2:
Mailing Address - City:AMERY
Mailing Address - State:WI
Mailing Address - Zip Code:54001-1439
Mailing Address - Country:US
Mailing Address - Phone:715-268-8000
Mailing Address - Fax:715-268-0381
Practice Address - Street 1:632 US HIGHWAY 8 W
Practice Address - Street 2:
Practice Address - City:TURTLE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54889-4411
Practice Address - Country:US
Practice Address - Phone:715-822-7500
Practice Address - Fax:715-822-7221
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7897-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily