Provider Demographics
NPI:1477698793
Name:ERICKSON, LINDA MARIE (AUD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MARIE
Other - Last Name:DONALDSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 19087
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66285-9087
Mailing Address - Country:US
Mailing Address - Phone:913-262-5855
Mailing Address - Fax:913-262-5869
Practice Address - Street 1:12541 FOSTER ST STE 220
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2301
Practice Address - Country:US
Practice Address - Phone:913-498-2827
Practice Address - Fax:913-498-1052
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1340231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS05120OtherNATIONAL EAR CARE PLAN
KS640004507OtherTRAVELERS MEDICARE
KS100398790AMedicaid
KS29267012OtherBLUE CROSS BLUE SHIELD KC
KS4500202OtherUNITED HEALTHCARE
KS5358640OtherAETNA
KS5358640OtherAETNA