Healthcare Provider Details

I. General information

NPI: 1467890285
Provider Name (Legal Business Name): ERICA DAWN KILIK R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2013
Last Update Date: 11/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 RESEARCH PKWY
COLORADO SPRINGS CO
80920-1025
US

IV. Provider business mailing address

1975 RESEARCH PKWY
COLORADO SPRINGS CO
80920-1025
US

V. Phone/Fax

Practice location:
  • Phone: 719-867-2100
  • Fax:
Mailing address:
  • Phone: 719-867-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number106149
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: