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General NPI Number Information
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NPI Number | 1700534724
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Entity Type | Individual
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Provider Name | ALYSSA ERICKSON APRN
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Gender | Female
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 1301 9TH AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-6633
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Country | US
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Telephone | 941-345-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 18415 STATE ROAD 62
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City | PARRISH
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State | FL
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Zip | 34219-9029
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Country | US
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Telephone | 239-281-3638
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11018734
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License Number State | FL
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