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General NPI Number Information
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NPI Number | 1013152396
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Entity Type | Individual
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Provider Name | DR. ALICIA M ERICKSEN
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Gender | Female
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Dates
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Enumeration Date | 12/15/2008
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 945 E ZERO ST
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City | AINSWORTH
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State | NE
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Zip | 69210-1556
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Country | US
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Telephone | 402-387-2067
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Fax | 402-387-0298
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Provider Business Mailing Address
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Address Line | 945 E ZERO ST
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City | AINSWORTH
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State | NE
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Zip | 69210-1556
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Country | US
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Telephone | 402-387-2067
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Fax | 402-387-0298
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 322
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License Number State | NE
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