Provider Demographics
NPI:1356734172
Name:KNOERR, ERICA JANE (FNP)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:JANE
Last Name:KNOERR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4675 HILL ST
Mailing Address - Street 2:
Mailing Address - City:CASS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48726-1008
Mailing Address - Country:US
Mailing Address - Phone:989-683-8065
Mailing Address - Fax:989-683-8088
Practice Address - Street 1:5854 STATE ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:MI
Practice Address - Zip Code:48741-9524
Practice Address - Country:US
Practice Address - Phone:989-683-8065
Practice Address - Fax:989-683-8088
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-18
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704257477363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily