Individual provider · Type 1 NPI

Lisa M. Ericksen, PA-C

Medical Physician Assistant · Livonia, MI

NPI number 1366530354 Active

Practice location

29200 Schoolcraft Rd
Livonia, MI 48150-2228

Call (734) 523-2420 Map

Fax (734) 523-2464

Mailing address

318 Waverley Ave
Royal Oak, MI 48067-1339

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X5601001522 (MI)

Medical Physician Assistant: Definition to come...

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About NPI 1366530354

Lisa M. Ericksen, PA-C's National Provider Identifier is 1366530354, issued on Oct 11, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Livonia, MI. The record was last updated on Mar 19, 2021.