Individual
JESSICA S ERICSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN- FNP
Contact information
Practice address
3 RIVERSIDE CIR, ROANOKE, VA 24016
(540) 224-5170
Mailing address
3031 NORTHSIDE RD, ROANOKE, VA 24019-2707
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024170830
VA
Other
Enumeration date
06/14/2013
Last updated
07/31/2018
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