Provider Demographics
NPI:1306123963
Name:ERIKSSON, JULIE LORRAINE (NP-C)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:LORRAINE
Last Name:ERIKSSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29424-3519
Mailing Address - Country:US
Mailing Address - Phone:843-953-5520
Mailing Address - Fax:
Practice Address - Street 1:181 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29424-3519
Practice Address - Country:US
Practice Address - Phone:843-953-5520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4486363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily