Healthcare Provider Details

I. General information

NPI: 1205783735
Provider Name (Legal Business Name): KAIA ERICKSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1577 NEIL AVE
COLUMBUS OH
43210-1216
US

IV. Provider business mailing address

1577 NEIL AVE
COLUMBUS OH
43210-1216
US

V. Phone/Fax

Practice location:
  • Phone: 614-292-4041
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0042327
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: