| Doctor Name: | HEATHER ERICKSON |
| NPI Number: | 1124406848 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD,LD,CDE |
| License Number: | 21320325 |
| Business Practice Address: | 320 E Main St Crosby, MN - 564411645 |
| Business Phone Number: | 2185467000 |
| Business Fax Number: | 2185464400 |
| Mailing Address: | 320 E Main St, CROSBY |
| State: | MN |
| Postal Code: | 564411645 |
| Phone Number: | 2185467000 |
| Fax Number: | 2185464400 |
| NPI Enumeration Date: | 05/14/2015 |
| NPI Last Update Date: | 05/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | 21320325 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |