Provider Demographics
NPI:1518703164
Name:ERIKSEN, KAMREN LEI (MS, RDN, LDN)
Entity type:Individual
Prefix:MR
First Name:KAMREN
Middle Name:LEI
Last Name:ERIKSEN
Suffix:
Gender:M
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 HIDDEN GLEN WAY
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2951
Mailing Address - Country:US
Mailing Address - Phone:334-405-8397
Mailing Address - Fax:855-710-7150
Practice Address - Street 1:119 HIDDEN GLEN WAY
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-2951
Practice Address - Country:US
Practice Address - Phone:334-405-8397
Practice Address - Fax:855-710-7150
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL86372735133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered