Provider Demographics
NPI:1821537127
Name:BARTNICK, ERIN W (PA-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:W
Last Name:BARTNICK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:DODGEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53533-1176
Mailing Address - Country:US
Mailing Address - Phone:608-935-9227
Mailing Address - Fax:608-935-9227
Practice Address - Street 1:6602 GRAND TETON PLZ STE 100
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-2905
Practice Address - Country:US
Practice Address - Phone:608-828-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-20
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3924-23363AM0700X, 363AM0700X
WI9948-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical