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Individual
KENNETH WAYNE ERICKSON
Active
Individual
KENNETH WAYNE ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP14456
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP14456
CALIFORNIA NP CERTIFICATE
CA
Enumeration date
04/12/2007
Last updated
07/08/2007
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