Provider Demographics
NPI:1407474133
Name:ANDERSEN, ERIKA LEA (AGNP)
Entity Type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:LEA
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:MRS
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:AGNITSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:115 S PARK AVE
Mailing Address - Street 2:
Mailing Address - City:EAGLE GROVE
Mailing Address - State:IA
Mailing Address - Zip Code:50533-2219
Mailing Address - Country:US
Mailing Address - Phone:515-448-5185
Mailing Address - Fax:515-448-4405
Practice Address - Street 1:190 CENTRAL AVE S
Practice Address - Street 2:
Practice Address - City:MILACA
Practice Address - State:MN
Practice Address - Zip Code:56353-1123
Practice Address - Country:US
Practice Address - Phone:320-983-9010
Practice Address - Fax:218-824-8011
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH159559363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology