Individual
MR. CODY ERICSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
400 W MINERAL KING AVE, VISALIA, CA 93291-6237
(559) 624-5339
Mailing address
3350 W CAMBRIDGE AVE, VISALIA, CA 93277-4124
(707) 337-1023
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95009597
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95009597
BOARD OF REGISTERED NURSING (BRN)
CA
Enumeration date
05/11/2019
Last updated
06/11/2019
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