Individual
DAWN ERICKSEN-CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
19213 AMBER WAY, NOBLESVILLE, IN 46060-8349
(317) 797-1631
Mailing address
26 N HAWTHORNE LN, INDIANAPOLIS, IN 46219-5613
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71004710A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201229190
—
IN
01
—
28175006A
RN LICENSE
IN
01
—
71004710A
APN PRESCRIPTIVE AUTHORITY
IN
01
—
P01456970
MEDICARE RR
IN
Enumeration date
11/08/2013
Last updated
03/19/2019
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