Erika Leigh Bourdeaux, DNP, RN, CPNP-PC
Individual provider Active NPI Pediatric Nurse Practitioner · Beloit, WI
NPI 1487196895 · NPPES record last updated Nov 16, 2016
Key facts
- NPI
- 1487196895
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 7358-33 (WI)
- Practice address
- 2825 Prairie Ave
Beloit, WI 53511-1844 - Phone
- (608) 363-5500
- NPI assigned
- Nov 16, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health System Corporation | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 7358-33 | WI | Yes |
Addresses
Primary practice location
2825 Prairie Ave
Beloit, WI 53511-1844
Mailing address
2825 Prairie Ave
Beloit, WI 53511-1844
Phone (608) 363-5500
Other names
- Erika Leigh Kipp
Other providers in Beloit, WI
- Loria R. Boone
- Nathaniel S Bothfeld
- Bouc Family Wellness Center, LLC
- Geoffrey Thomas Bouc
- Peter Zenithen Bouc
- Susan G Bower
- Kate E Bowgren
- Erin L Bown
- Tammy Jo Boxleitner
- Savannah Marie Boyd
All providers in Beloit, WI · Pediatric Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.