NPI 1205184025

Ivy L Erickson, PAC

Practitioner Physician Assistant Onalaska, WI

Practice location

Address: 191 Theater Rd, Onalaska, WI 54650
Phone: (608) 785-0940
Mailing address: PO Box 860912 Provider Enrollment - Rst, Minneapolis, MN 55486-0912

Registered specialties (2)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 2923-23 (WI)

Other Physician Assistant providers in Wisconsin →

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 002336 (IA)

Registry record

NPI: 1205184025
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Aug 2012
Record last updated: 23 Jan 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.