Provider Demographics
NPI:1386326114
Name:ERIKSON, EMILY (RN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ERIKSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 GRANT CIR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:64034-9479
Mailing Address - Country:US
Mailing Address - Phone:913-406-5546
Mailing Address - Fax:
Practice Address - Street 1:901 LOCUST ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-2325
Practice Address - Country:US
Practice Address - Phone:816-922-3399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011017244163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice