Provider Demographics
NPI:1265898324
Name:MCKINNEY, ERICA ANN (DC)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:ANN
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:ANN
Other - Last Name:ACKERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3250 S PINEWOOD CREEK CT
Mailing Address - Street 2:APT 103
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-4384
Mailing Address - Country:US
Mailing Address - Phone:414-949-1741
Mailing Address - Fax:
Practice Address - Street 1:11300 75TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-7355
Practice Address - Country:US
Practice Address - Phone:262-925-2890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2016-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5150-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor