Individual
DEBORAH L ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 WEST BRADLEY AVE, PEORIA, IL 61625
(309) 241-6164
Mailing address
1501 WEST BRADLEY AVE, PEORIA, IL 61625
(309) 241-6164
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
41230313
IL
Other
Enumeration date
07/05/2022
Last updated
07/05/2022
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