Provider Demographics
NPI:1366901365
Name:ERICKSEN, MEGHAN P (FNP)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:P
Last Name:ERICKSEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:ELIZABETH
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HYGEIA DRIVE
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4755 OGLETOWN STANTON ROAD
Practice Address - Street 2:SUITE 1070
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-733-1663
Practice Address - Fax:302-733-1616
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR223989163W00000X
DEL1-0040336163W00000X
DELG-0001228363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse