Provider Demographics
NPI:1174803639
Name:PECHOUS, ERIN LEEANN (LPN)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LEEANN
Last Name:PECHOUS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:LEEANN
Other - Last Name:KYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1158 E BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:WHITEWATER
Mailing Address - State:WI
Mailing Address - Zip Code:53190-2169
Mailing Address - Country:US
Mailing Address - Phone:920-728-0515
Mailing Address - Fax:
Practice Address - Street 1:1158 E BLUFF RD
Practice Address - Street 2:
Practice Address - City:WHITEWATER
Practice Address - State:WI
Practice Address - Zip Code:53190-2169
Practice Address - Country:US
Practice Address - Phone:920-728-0515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-27
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3100779-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse