Provider Demographics
NPI:1992756720
Name:SCHELLHAAS, ERICA A (PA-C)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:A
Last Name:SCHELLHAAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:A
Other - Last Name:GUMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:FROEDTERT & MED COLLEGE CLIN - WEST
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9200 WEST WISCONSIN AVENUE
Practice Address - Street 2:FROEDTERT & MED COLLEGE CLIN - WEST
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-805-3666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1616363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41982000Medicaid
006906261WOtherHUMANA
WI088P 73-601Medicare PIN
WI41982000Medicaid