Provider Demographics
NPI:1417972092
Name:MICHAUD, ERICA HELEN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:HELEN
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2635 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-8209
Mailing Address - Country:US
Mailing Address - Phone:970-244-2551
Mailing Address - Fax:
Practice Address - Street 1:DEPT 0861
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80256-0822
Practice Address - Country:US
Practice Address - Phone:866-898-7136
Practice Address - Fax:616-975-9827
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2015-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONP-990038363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CONP-990038OtherNP LICENSE
CO75109221Medicaid
CORN-197305OtherRN LICENSE
CO259064YQALMedicare PIN