Individual
MARK ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
201 STATE ST, ERIE, PA 16550-0001
(703) 966-6119
Mailing address
201 STATE ST, ERIE, PA 16550-0001
(703) 966-6119
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
699868
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN699868
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
699868
PA RN LICENSE
PA
Enumeration date
07/29/2024
Last updated
06/06/2025
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