Provider Demographics
NPI:1699385781
Name:EICH, ERIKA ANN (PA)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:ANN
Last Name:EICH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 S CAMDEN AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-7218
Mailing Address - Country:US
Mailing Address - Phone:605-212-2330
Mailing Address - Fax:
Practice Address - Street 1:1417 S CLIFF AVE STE 10
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1014
Practice Address - Country:US
Practice Address - Phone:605-322-3683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1252363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant