Provider Demographics
NPI:1972909729
Name:STURSA-PATENAUDE, ERICKA (APRN-RX, FNP, IBCLC)
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:STURSA-PATENAUDE
Suffix:
Gender:F
Credentials:APRN-RX, FNP, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 MALABEY ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-5020
Mailing Address - Country:US
Mailing Address - Phone:210-251-7452
Mailing Address - Fax:
Practice Address - Street 1:1516 MALABEY ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-5020
Practice Address - Country:US
Practice Address - Phone:210-251-7452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0079136163W00000X
HIAPRN-4511-0363L00000X
TX867436163WL0100X
COL58165163WL0100X
HIRN-108915163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant