Provider Demographics
NPI:1114731106
Name:DIERKENS, ERICA (IBCLC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:DIERKENS
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 COLONY RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-6561
Mailing Address - Country:US
Mailing Address - Phone:734-913-0794
Mailing Address - Fax:
Practice Address - Street 1:2830 COLONY RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6561
Practice Address - Country:US
Practice Address - Phone:734-913-0794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula