Provider Information for 1689034118
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KRYSTINA ERICHSEN
Sex: Female
NPI: 1689034118
Last Updated: 2016-02-25
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1689034118 | ||||||||||||||||
| Enumeration Date | 2016-02-25 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 1272 NE WINDSOR DR LEES SUMMIT, MO 64086-5594 United States Phone: 816-246-4465 | Fax:816-524-7008 | ||||||||||||||||
| Primary Practice Address | 1272 NE WINDSOR DR LEES SUMMIT, MO 64086-5594 United States Phone: 816-246-4465 | Fax:816-524-7008 | ||||||||||||||||
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