Provider Demographics
NPI:1790066801
Name:ERICKSON, MEGHAN ANN (APRN)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ANN
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:APRN
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 139
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-0139
Mailing Address - Country:US
Mailing Address - Phone:406-443-2977
Mailing Address - Fax:406-443-2960
Practice Address - Street 1:3240 DREDGE DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-0548
Practice Address - Country:US
Practice Address - Phone:406-443-2977
Practice Address - Fax:406-443-2960
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT45274363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health