Erickson, Michael

Erickson, Michael is an individual health care provider with primary practice located at 7309 N Knoxville Ave , Peoria IL 61614-2085. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Erickson, Michael can be contacted via phone (309) 282-0827.

Contact Information

Primary practice address
7309 N Knoxville Ave Peoria IL 61614-2085
Phone: (309) 282-0827
Fax: (309) 683-1003
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X Illinois

Profile Details

NPI number 1902874696
LBN Legal business name Erickson, Michael
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2006
Last updated Jul 8th, 2007 - about 17 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 1902874696 NPPES
Illinois Other 7232002 BLUE CROSS BLUE SHIELD

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