Erickson, Kathy Clydean

Erickson, Kathy Clydean is an individual health care provider with primary practice located at 1600 E Evergreen St Suite C, Cameron MO 64429-2400. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Erickson, Kathy Clydean can be contacted via phone (816) 632-2139.

Contact Information

Primary practice address
1600 E Evergreen St Suite C Cameron MO 64429-2400
Phone: (816) 632-2139
Fax: (816) 632-2315
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 065142 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 065142 Missouri

Profile Details

NPI number 1316921430
LBN Legal business name Erickson, Kathy Clydean
Credentials RN, CS, FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated Dec 2nd, 2010 - about 15 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 1316921430 NPPES
Missouri MEDICAID 427786421
Missouri Other P00607932

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