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General NPI Number Information
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NPI Number | 1487141057
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Entity Type | Individual
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Provider Name | ERICKA NATASHA OLIVER-LINEN MD
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Gender | Female
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 22201 MOROSS RD STE 222
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City | DETROIT
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State | MI
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Zip | 48236-2169
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Country | US
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Telephone | 313-343-3964
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CHILDRENS PL CB 8116
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City | ST. LOUIS
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State | MO
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Zip | 63110
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Country | US
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Telephone | 314-454-2527
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Fax | 314-747-8880
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2021025587
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301502421
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2021013996
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 4301502421
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License Number State | MI
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