Provider Demographics
NPI:1275869596
Name:ERIKSSON, ELIZABETH (ARNP, ANP-BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ERIKSSON
Suffix:
Gender:F
Credentials:ARNP, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1893 N CLYDE MORRIS BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-5536
Mailing Address - Country:US
Mailing Address - Phone:386-675-6778
Mailing Address - Fax:386-675-6782
Practice Address - Street 1:1893 N CLYDE MORRIS BLVD STE 120
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5536
Practice Address - Country:US
Practice Address - Phone:386-675-6778
Practice Address - Fax:386-675-6782
Is Sole Proprietor?:No
Enumeration Date:2009-10-21
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3354322363LA2200X
FLARNP3354322363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009122900Medicaid