Healthcare Provider Details
I. General information
NPI: 1316114739
Provider Name (Legal Business Name): KRISTINA L ERICKSON OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/14/2008
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2901 S OVERLAND RD
ONEIDA WI
54155-8959
US
IV. Provider business mailing address
PO BOX 365
ONEIDA WI
54155-0365
US
V. Phone/Fax
- Phone: 920-869-2711
- Fax:
- Phone: 920-869-2711
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | 2862 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: