MEDICARE: JENNA ERICKSON

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	104100000X	Social Worker		MN

General Provider Information

NPI Number	:	1770379281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA ERICKSON

Provider Business Mailing Address
First Line	:	3740 FALCON WAY
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55123-2491
Country	:	US
Telephone Number	:	612-323-2367
Fax Number	:	612-323-2367

Provider Business Practice Location Address
First Line	:	2912 N 2ND ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-1606
Country	:	US
Telephone Number	:	612-234-4242
Fax Number	:

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

Provider Enumeration Date	:	04/19/2025
Last Update Date	:	04/19/2025

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Directions to “ JENNA ERICKSON ” Practice Location

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