Provider Demographics
NPI:1245685403
Name:DICK, ERIKA DAWN (APRN)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:DAWN
Last Name:DICK
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 946
Mailing Address - Street 2:
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720-0946
Mailing Address - Country:US
Mailing Address - Phone:620-431-2500
Mailing Address - Fax:620-431-4418
Practice Address - Street 1:1501 WEST 7TH ST.
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-2516
Practice Address - Country:US
Practice Address - Phone:620-432-5588
Practice Address - Fax:620-431-1192
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-77162-051363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care