Individual
MARY M ERICKSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RNC PNP MPH
Contact information
Practice address
CHILDREN'S PRIMARY CLINIC - STPL, 347 NORTH SMITH AVENUE, ST PAUL, MN 55102
(651) 220-6789
(651) 220-6807
Mailing address
CHILDREN'S HEALTH CARE, 2910 CENTRE POINTE DRIVE 35-121A, ROSEVILLE, MN 55113
(651) 855-2327
(651) 855-2310
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R073480-0
MN
Other
Enumeration date
08/03/2005
Last updated
07/08/2007
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