Erickson, Evelyn J

Erickson, Evelyn J is an individual health care provider with primary practice located at 3701 12Th St N Suite 100, St Cloud MN 56303. She recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as her primary health care specialty. Erickson, Evelyn J can be contacted via phone (320) 253-7257.

Contact Information

Primary practice address
3701 12Th St N Suite 100 St Cloud MN 56303
Phone: (320) 253-7257
Fax: (320) 251-2938
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 37346 Minnesota

Profile Details

NPI number 1568480366
LBN Legal business name Erickson, Evelyn J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Nov 29th, 2010 - about 14 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 1568480366 NPPES
Minnesota MEDICAID 145719500
Minnesota Other 111011
Minnesota Other 1006655
Minnesota Other 6T195ER
Minnesota Other 249000019
Minnesota Other 1301024
Minnesota Other 145719500

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