Provider Demographics
NPI:1427527613
Name:KOERNER, ERIKA KRISTIN (AGPCNP-BC)
Entity type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:KRISTIN
Last Name:KOERNER
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 ANDOVER DR
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-9554
Mailing Address - Country:US
Mailing Address - Phone:734-645-7660
Mailing Address - Fax:
Practice Address - Street 1:300 W WASHINGTON AVE STE 300
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2160
Practice Address - Country:US
Practice Address - Phone:517-205-1305
Practice Address - Fax:517-205-1306
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704239361363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner