| NPI | 1124319082 |
|---|---|
| Former Name | MICHELLE ERICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112341) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 5375353121) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2017-11-24 |