Provider Demographics
NPI:1174932594
Name:HADDON, ERIKA KRISTINE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:KRISTINE
Last Name:HADDON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MISS
Other - First Name:ERIKA
Other - Middle Name:KRISTINE
Other - Last Name:HADDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2221 VILLAGE WOODS DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2512
Mailing Address - Country:US
Mailing Address - Phone:810-429-4902
Mailing Address - Fax:
Practice Address - Street 1:414 PERRY RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1467
Practice Address - Country:US
Practice Address - Phone:810-694-8423
Practice Address - Fax:810-694-9280
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAG0714165363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner