Doctor Name: | MS. KATHRYN ELLEN ERICKSEN |
NPI Number: | 1023240116 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | GNP |
License Number: | 340744-1 |
Business Practice Address: | 3700 Old Vestal Rd Vestal, NY - 138502229 |
Business Phone Number: | 6072212745 |
Business Fax Number: | |
Mailing Address: | 385 Ingraham Hill Rd, BINGHAMTON |
State: | NY |
Postal Code: | 139035513 |
Phone Number: | 6076210313 |
Fax Number: | |
NPI Enumeration Date: | 08/22/2009 |
NPI Last Update Date: | 08/22/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | 340744-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |