Healthcare Provider Details

I. General information

NPI: 1740163682
Provider Name (Legal Business Name): JESSICA ERKKILA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3630 US 41 W
MARQUETTE MI
49855-9499
US

IV. Provider business mailing address

521 W BARAGA AVE APT 1
MARQUETTE MI
49855-4517
US

V. Phone/Fax

Practice location:
  • Phone: 906-662-6310
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302417700
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: