Individual
SHANNON ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
601 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87102-3619
(505) 727-8358
Mailing address
2300 DIAMOND MESA TRL SW APT 4806, ALBUQUERQUE, NM 87121-3748
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-1294
NM
Other
Enumeration date
06/20/2019
Last updated
06/20/2019
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