MEDICARE: ERICA DAWN KILIK R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	106149	CO

General Provider Information

NPI Number	:	1467890285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA DAWN KILIK R.N.

Provider Business Mailing Address
First Line	:	1975 RESEARCH PKWY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1025
Country	:	US
Telephone Number	:	719-867-2100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1975 RESEARCH PKWY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1025
Country	:	US
Telephone Number	:	719-867-2100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2013
Last Update Date	:	11/14/2013

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