Healthcare Provider Details

I. General information

NPI: 1528679305
Provider Name (Legal Business Name): ERIKO APRILIANDO NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2020
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5076 BISHOP ST
DETROIT MI
48224-2143
US

IV. Provider business mailing address

5076 BISHOP ST
DETROIT MI
48224-2143
US

V. Phone/Fax

Practice location:
  • Phone: 616-214-0228
  • Fax:
Mailing address:
  • Phone: 616-214-0228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704313962
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704313962
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704313962
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4704313962
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: