NPI | 1225523004 |
---|---|
Former Name | ALICIA MAE ERICKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R39910) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2344340) |
163W00000X Registered Nurse (Licence: ND R39910) | |
Enumeration Date | 2018-06-25 |
Last Update Date | 2020-02-24 |