Provider Demographics
NPI:1972487817
Name:BERQUIST, EMILY KENDRA (APNP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:KENDRA
Last Name:BERQUIST
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:KENDRA
Other - Last Name:RASCHIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11901 N BRYANT RD
Mailing Address - Street 2:
Mailing Address - City:FORT ATKINSON
Mailing Address - State:WI
Mailing Address - Zip Code:53538-9216
Mailing Address - Country:US
Mailing Address - Phone:920-691-2106
Mailing Address - Fax:
Practice Address - Street 1:1969 W HART RD
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-2230
Practice Address - Country:US
Practice Address - Phone:608-364-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1718533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily