Individual
JENNIFER ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1772 STEIGER LAKE LN, VICTORIA, MN 55386-7723
(952) 443-9888
Mailing address
2188 RED FOX CIR, CHANHASSEN, MN 55317-8436
(612) 670-0948
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9241
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001442700
—
MN
01
—
017J6KI
BCBS MN
MN
01
—
1311578
CIGNA
MN
01
—
16154051
FISERV
—
01
—
169036
UCARE
MN
01
—
4600402
MEDICA
MN
01
—
565581028804
PREFFERED ONE
MN
01
—
76842
HEALTHPARTNERS
MN
Enumeration date
05/05/2014
Last updated
05/05/2014
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