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General NPI Number Information
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NPI Number | 1679493548
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Entity Type | Individual
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Provider Name | ELLA HAUCK ERICKSON DNP, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 1952 HARRISON DR # 1
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City | EVANSTON
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State | WY
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Zip | 82930-3241
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Country | US
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Telephone | 307-288-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 1224 E JACKSON AVE
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City | RIVERTON
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State | WY
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Zip | 82501-3841
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Country | US
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Telephone | 307-856-3463
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 55509
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License Number State | WY
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