Travis Erickson, | |
240 Willow St, Tyler, MN 56178-1201 | |
(507) 247-5521 | |
Not Available |
Full Name | Travis Erickson |
---|---|
Gender | Male |
Speciality | Nurse Practitioner |
Experience | 6 Years |
Location | 240 Willow St, Tyler, Minnesota |
Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467927657 | NPI | - | NPPES |
1467927657 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 7183 (Minnesota) | Primary |
363LA2100X | Nurse Practitioner - Acute Care | CP001466 (South Dakota) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Prairie Lakes Healthcare System, Inc | Watertown, SD | Hospital |
Huron Regional Medical Center | Huron, SD | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Prairie Lakes Health Care Systems Inc | 8628987823 | 85 |
Entity Name | Huron Regional Medical Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1154312429 PECOS PAC ID: 2769393388 Enrollment ID: O20040123000946 |
Entity Name | Prairie Lakes Health Care Systems Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720166002 PECOS PAC ID: 8628987823 Enrollment ID: O20040202000187 |
Entity Name | Dunes Anesthesia Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801810585 PECOS PAC ID: 9537141254 Enrollment ID: O20040604000767 |
Mailing Address | Practice Location Address |
---|---|
Travis Erickson, 300 S Bruce St, Marshall, MN 56258-1934 Ph: (507) 247-5521 | Travis Erickson, 240 Willow St, Tyler, MN 56178-1201 Ph: (507) 247-5521 |
Candice Lou Vanderplaats, RN CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 240 Willow Street, Tyler, MN 56178 Phone: 507-247-5921 Fax: 507-247-5184 | |
Kassandra Elizabeth Anderson, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 240 Willow St, Tyler, MN 56178 Phone: 507-247-5521 |