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General NPI Number Information
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NPI Number | 1285358341
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Entity Type | Individual
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Provider Name | OLIVIA ERICKSON CPM, LTM, CLC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 968 GRAND AVE
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City | SAINT PAUL
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State | MN
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Zip | 55105-3014
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Country | US
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Telephone | 651-895-2520
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Fax | 833-449-3321
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Provider Business Mailing Address
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Address Line | 968 GRAND AVE
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City | SAINT PAUL
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State | MN
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Zip | 55105-3014
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Country | US
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Telephone | 651-895-2520
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Fax | 833-449-3321
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | 1112
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | 343324
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License Number State | MN
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