Ericsson, Kristina Renee
Ericsson, Kristina Renee is an individual health care provider with primary practice located at 600 New Waverly Pl Ste 310 , Cary NC 27518. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Ericsson, Kristina Renee can be contacted via phone (919) 694-0025.Contact Information
Primary practice address
600 New Waverly Pl Ste 310
Cary NC 27518
Phone: (919) 694-0025
Fax: (919) 678-6901
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 2016-01844 | North Carolina |
Profile Details
| NPI number | 1366640658 |
|---|---|
| LBN Legal business name | Ericsson, Kristina Renee |
| Credentials | MD, MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2007 |
| Last updated | May 29th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366640658 | NPPES |
| North Carolina | Other | NCU719B | MEDICARE PTAN |
| North Carolina | MEDICAID | 036127970 | MEDICARE PTAN |
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