Provider Demographics
NPI:1336391382
Name:ERICKSON, KAREN (ND, LM)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:ND, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2769 SNOWFLAKE DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-4843
Mailing Address - Country:US
Mailing Address - Phone:208-383-4833
Mailing Address - Fax:
Practice Address - Street 1:2769 SNOWFLAKE DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-4843
Practice Address - Country:US
Practice Address - Phone:208-383-4833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA169176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife