MEDICARE: MS. ERICKA GILSON ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	AP60339514	WA
2	363L00000X	Nurse Practitioner	AP60339514	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AP60339514	OTHER	WA	STATE LICENSE

General Provider Information

NPI Number	:	1093056384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERICKA GILSON ARNP

Provider Business Mailing Address
First Line	:	8415 MYERS RD E
Second Line	:
City	:	BONNEY LAKE
State	:	WA
Zip	:	98391-7043
Country	:	US
Telephone Number	:	253-600-7170
Fax Number	:	253-237-9444

Provider Business Practice Location Address
First Line	:	8415 MYERS RD E
Second Line	:
City	:	BONNEY LAKE
State	:	WA
Zip	:	98391-7043
Country	:	US
Telephone Number	:	253-600-7170
Fax Number	:	253-237-9444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2013
Last Update Date	:	07/12/2024

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