Provider Demographics
NPI:1700027539
Name:ERICKSON, KERI S (RRT)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:S
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:
Other - Last Name:SNIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3000 NEW BERN AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1231
Mailing Address - Country:US
Mailing Address - Phone:919-350-6944
Mailing Address - Fax:919-231-5127
Practice Address - Street 1:2610 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1821
Practice Address - Country:US
Practice Address - Phone:919-350-6944
Practice Address - Fax:919-231-5127
Is Sole Proprietor?:No
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA-1938227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered