Provider Demographics
NPI:1306288428
Name:ERICKSON, RITA (NP)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1225 W GRAND RIVER AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-3975
Mailing Address - Country:US
Mailing Address - Phone:517-548-0010
Mailing Address - Fax:517-548-5326
Practice Address - Street 1:1225 W GRAND RIVER AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-3975
Practice Address - Country:US
Practice Address - Phone:517-548-0010
Practice Address - Fax:517-548-5326
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704216880363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health