Provider Demographics
NPI:1306478219
Name:ERICKSON, ALESHA (RPH)
Entity type:Individual
Prefix:
First Name:ALESHA
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 LAKE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-9100
Mailing Address - Country:US
Mailing Address - Phone:972-540-1172
Mailing Address - Fax:972-540-1206
Practice Address - Street 1:2901 LAKE FOREST DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-9100
Practice Address - Country:US
Practice Address - Phone:972-540-1172
Practice Address - Fax:972-540-1206
Is Sole Proprietor?:No
Enumeration Date:2020-02-08
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0174841835P0018X
TX382041835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist