Provider Demographics
NPI:1861775421
Name:STICKNEY, ERIN N (APRN)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:N
Last Name:STICKNEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2401 E AVE UNIT 3077
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-0347
Mailing Address - Country:US
Mailing Address - Phone:308-455-1500
Mailing Address - Fax:308-455-1502
Practice Address - Street 1:4715 2ND AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2463
Practice Address - Country:US
Practice Address - Phone:308-455-1500
Practice Address - Fax:308-455-1502
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111303363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1952661654Medicaid
NE1952661654Medicaid