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Individual

ERIK R EISBERNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2901 W KINNICKINNIC RIVER PKWY, SUITE #511, MILWAUKEE, WI 53215-3677
(414) 649-3780
Mailing address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9201
(262) 329-8150

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6915
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1346603032
WI
Enumeration date
03/31/2016
Last updated
12/02/2021
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