NPI 1538576962

Theresa Ertl, RN

Practitioner Registered Nurse Sparta, WI

Practice location

Address: 1014 Long CT, Sparta, WI 54656-2552
Phone: (920) 410-8539

Registered specialties

Registered Nurse Primary

Nursing Service Providers Taxonomy 163W00000X Licence 173659-30 (WI)

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Registry record

NPI: 1538576962
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Jul 2014
Record last updated: 17 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.