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Individual
KARA ERICKSON
Active
Individual
KARA ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
261
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0437427
BCBS PROVIDER NUMBER
MT
05
—
0437427
—
MT
01
—
261
MT STATELIC NUMBER
MT
Enumeration date
10/03/2006
Last updated
02/25/2014
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