Individual
KRISTIN ELIZABETH HANINGTON ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
132 HOSPITAL DR, WATERTOWN, WI 53098
(920) 261-2020
(920) 261-0457
Mailing address
132 HOSPITAL DR, WATERTOWN, WI 53098-3304
(920) 261-2020
(920) 261-0457
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3212-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3212-23
LICENSE NUMBER
WI
Enumeration date
11/28/2007
Last updated
11/15/2018
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