Individual
LISA MARIE ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3850
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
266738
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110094672A
—
MA
Enumeration date
10/24/2007
Last updated
06/08/2021
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