Healthcare Provider Details

I. General information

NPI: 1861322042
Provider Name (Legal Business Name): VANEICA ERICKSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 1/2 E THAYER AVE
BISMARCK ND
58501-4655
US

IV. Provider business mailing address

1404 1/2 E THAYER AVE
BISMARCK ND
58501-4655
US

V. Phone/Fax

Practice location:
  • Phone: 701-934-6366
  • Fax:
Mailing address:
  • Phone: 701-934-6366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberERI714441
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: