Ericksen-Clarke, Dawn

Ericksen-Clarke, Dawn is an individual health care provider with primary practice located at 19213 Amber Way , Noblesville IN 46060-8349. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Ericksen-Clarke, Dawn can be contacted via phone (317) 797-1631.

Contact Information

Primary practice address
19213 Amber Way Noblesville IN 46060-8349
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 71004710A Indiana

Profile Details

NPI number 1700215829
LBN Legal business name Ericksen-Clarke, Dawn
Credentials ANP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2013
Last updated Mar 19th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700215829 NPPES
Indiana Other P01456970 MEDICARE RR
Indiana Other 28175006A MEDICARE RR
Indiana MEDICAID 201229190 MEDICARE RR
Indiana Other 71004710A MEDICARE RR

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