Provider Demographics
NPI:1164501581
Name:ERICKSON, STEVEN F (PA-C)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:F
Last Name:ERICKSON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 WILBUR MAY PKWY APT 3602
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-3097
Mailing Address - Country:US
Mailing Address - Phone:775-225-9366
Mailing Address - Fax:
Practice Address - Street 1:781 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1320
Practice Address - Country:US
Practice Address - Phone:775-329-1019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV843363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
100344Medicare ID - Type Unspecified