Kim Erickson, M.S.,R.N.,C.P.N.P

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP108129 Issued in TX

Practice address

11661 Preston Rd Ste 120
Dallas, TX 75230-6199

Phone

(214) 363-7242

NPI assigned

Sep 24, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Master of Science, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1568612745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11661 PRESTON RD STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306199",
            "telephone_number": "214-363-7242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 PRESTON RD STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306199",
            "telephone_number": "214-363-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "KIM",
        "credential": "M.S.,R.N.,C.P.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "502426",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP108129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erickson Health Medical Group of Texas PA
• Erickson Health Medical Group of Texas, PA
• Elise Erickson, OTR
• James Blake Erickson
• Judith G Erickson, MD
• Linda Lucia Erickson, SLP
• Bethany Ericson
• Laura Ericson, BCBA
• Lucy Rose Ericson, OTR
• Erik Fetner, M.D., P.a.

• Pediatric Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.