Provider Demographics
NPI:1588465934
Name:O'CONNOR, ERIN BETH
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:BETH
Last Name:O'CONNOR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:BETH
Other - Last Name:LERCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N1232 THRUSH DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54942-8718
Mailing Address - Country:US
Mailing Address - Phone:920-312-2453
Mailing Address - Fax:
Practice Address - Street 1:2701 E ENTERPRISE AVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7729
Practice Address - Country:US
Practice Address - Phone:920-954-2551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI240575-30163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine