Provider Demographics
NPI:1205922168
Name:ERICKSON, LAUREN KAY (OTD OTR/L)
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:KAY
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:OTD OTR/L
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:KAY
Other - Last Name:SENN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2810 W 35TH ST
Mailing Address - Street 2:STE 2
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2909
Mailing Address - Country:US
Mailing Address - Phone:308-237-7388
Mailing Address - Fax:308-237-7394
Practice Address - Street 1:2810 W 35TH ST
Practice Address - Street 2:STE 2
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2909
Practice Address - Country:US
Practice Address - Phone:308-237-7388
Practice Address - Fax:308-237-7394
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1023225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE39683OtherBLUE CROSS/BLUE SHIELD
099461011Medicare PIN