Erin Kathleen Audiss
Individual provider Active NPI Registered Nurse · Montello, WI
NPI 1972117430 · NPPES record last updated Sep 2, 2020
Key facts
- NPI
- 1972117430
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 254414 (WI)
- Practice address
- 42 Main St
Montello, WI 53949-9730 - Phone
- (608) 408-0165
- NPI assigned
- Sep 2, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 254414 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 254414 | WI | Yes |
Addresses
Primary practice location
42 Main St
Montello, WI 53949-9730
Mailing address
42 Main St
Montello, WI 53949-9730
Phone (608) 408-0165
Other providers in Montello, WI
- Aurora Pharmacy Inc
- Mikayla Ann Breneman
- Mindy Kay Brown
- Community Health Network
- County of Marquette
All providers in Montello, WI · Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2020. 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.