Individual
MS. CARRIE KAY ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5003 CROGANS WAY RD, COUNCIL BLUFFS, IA 51501-8616
(402) 320-8796
Mailing address
5003 CROGANS WAY RD, COUNCIL BLUFFS, IA 51501-8616
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
00465
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00465
IA ATH. TRAINING LICENSE
IA
01
—
080202275
BOC CERTIFICATION
—
Enumeration date
03/20/2007
Last updated
01/31/2020
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