| NPI | 1750163473 |
|---|---|
| Former Name | COURTNEY LARAE ERICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10022546) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: OR 201902333RN) |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2024-03-12 |