Organization
THRIVEMED, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA REIGLE NP (NURSE PRACTITIONER)
(262) 643-4900
Entity
Organization
Contact information
Practice address
11501 N PORT WASHINGTON RD STE G-30, MEQUON, WI 53092-3483
(262) 643-4900
(262) 643-4901
Mailing address
11501 N PORT WASHINGTON RD STE G-30, MEQUON, WI 53092-3483
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
333600000X
Pharmacy
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
12/18/2024
Last updated
12/18/2024
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