Provider Demographics
NPI:1396215802
Name:ERICKSON, CHOLENA (LAC, OMD)
Entity Type:Individual
Prefix:
First Name:CHOLENA
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:LAC, OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 CONNER DR STE 103
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7040
Mailing Address - Country:US
Mailing Address - Phone:919-933-4151
Mailing Address - Fax:919-967-9888
Practice Address - Street 1:109 CONNER DR STE 103
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7040
Practice Address - Country:US
Practice Address - Phone:919-933-4151
Practice Address - Fax:919-967-9888
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC008171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist