Provider Demographics
NPI:1093056384
Name:GILSON, ERICKA (ARNP)
Entity type:Individual
Prefix:MS
First Name:ERICKA
Middle Name:
Last Name:GILSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ERICKA
Other - Middle Name:
Other - Last Name:GILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP, FNP-C
Mailing Address - Street 1:8415 MYERS RD E
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-7043
Mailing Address - Country:US
Mailing Address - Phone:253-600-7170
Mailing Address - Fax:253-237-9444
Practice Address - Street 1:8415 MYERS RD E
Practice Address - Street 2:
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-7043
Practice Address - Country:US
Practice Address - Phone:253-600-7170
Practice Address - Fax:253-237-9444
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60339514207Q00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP60339514OtherSTATE LICENSE
WAG8919174Medicare PIN