Healthcare Provider Details

I. General information

NPI: 1134497399
Provider Name (Legal Business Name): BARBARA ANN ERICKSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2011
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S 6TH ST GOVERNMENT CENTER A1400
MINNEAPOLIS MN
55487-0999
US

IV. Provider business mailing address

300 S 6TH ST GOVERNMENT CENTER A1400
MINNEAPOLIS MN
55487-0999
US

V. Phone/Fax

Practice location:
  • Phone: 612-596-8466
  • Fax: 612-677-6248
Mailing address:
  • Phone: 612-596-8466
  • Fax: 612-677-6248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR59232-7
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: