Provider Demographics
NPI:1053101998
Name:ERIKSON, KASSIDY ANN
Entity type:Individual
Prefix:
First Name:KASSIDY
Middle Name:ANN
Last Name:ERIKSON
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3561 E 106TH AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-1575
Mailing Address - Country:US
Mailing Address - Phone:720-384-8105
Mailing Address - Fax:
Practice Address - Street 1:3561 E 106TH AVE
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-1575
Practice Address - Country:US
Practice Address - Phone:720-384-8105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician