Provider Demographics
NPI:1598546822
Name:SKALICKY, AERIKA
Entity Type:Individual
Prefix:
First Name:AERIKA
Middle Name:
Last Name:SKALICKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 95
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:ND
Mailing Address - Zip Code:58256-0095
Mailing Address - Country:US
Mailing Address - Phone:701-721-0290
Mailing Address - Fax:
Practice Address - Street 1:430 OXFORD STREET STOP 9025
Practice Address - Street 2:CNPD BUILDING ROOM 349
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58202-5820
Practice Address - Country:US
Practice Address - Phone:701-777-4521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program