Provider Demographics
NPI:1942691969
Name:ERICKSON, NATALIE (ATC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2344 ENERGY PARK DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108-1511
Mailing Address - Country:US
Mailing Address - Phone:612-672-7023
Mailing Address - Fax:651-917-1555
Practice Address - Street 1:2344 ENERGY PARK DR
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-1511
Practice Address - Country:US
Practice Address - Phone:612-672-7023
Practice Address - Fax:651-917-1555
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN20712255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer