SHELLY MARIE ERICKSON (NPI# 1124543244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124543244 |
| Entity Type | Individual |
| Full Name | SHELLY MARIE ERICKSON |
| Credential | FNP |
| Practice Address |
2946 E Banner Gateway Dr Gilbert AZ 85234-2165 |
| Mailing Address |
19755 E Willow Dr Queen Creek AZ 85142-9430 |
| Practice Telephone | 4802566444 |
| Mailing Telephone | 4802094631 |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2017-08-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP10486 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2946 E BANNER GATEWAY DR |
| City | GILBERT |
| State | AZ |
| Zip Code | 85234-2165 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841291929 | Bryan Y Wong | Internal Medicine | 2946 E Banner Gateway Dr, Gilbert, AZ 85234 | 2005-08-10 |
| 1154932051 | Margaret Capozzi | Nurse Practitioner | 2946 E Banner Gateway Dr, Gilbert, AZ 85234-2165 | 2020-08-13 |
| 1588288708 | Lisa Thompson | Pharmacist | 2946 E Banner Gateway Dr, Gilbert, AZ 85234-2165 | 2020-06-03 |
| 1265068456 | Alexandra Erin Chambers | Pharmacist | 2946 E Banner Gateway Dr, Gilbert, AZ 85234-2165 | 2020-03-19 |
| 1154896058 | Jamie Lee Boma | Physician Assistant | 2946 E Banner Gateway Dr, Gilbert, AZ 85234 | 2018-10-06 |
| 1750886867 | Kristin D. Embry | Physician Assistant | 2946 E Banner Gateway Dr, Gilbert, AZ 85234-2165 | 2018-03-29 |
| 1801315262 | Peter Do | Physician Assistant | 2946 E Banner Gateway Dr, Gilbert, AZ 85234-2165 | 2017-09-15 |
| 1073050456 | Soffia Elisabet Palsdottir | Psychologist | 2946 E Banner Gateway Dr, Gilbert, AZ 85234-2165 | 2017-01-24 |
| 1114479870 | Nathan Cochrane | Physician Assistant | 2946 E Banner Gateway Dr, Gilbert, AZ 85234-2165 | 2016-10-28 |
| 1407300189 | Kayla Ellen Davies | Nurse Practitioner | 2946 E Banner Gateway Dr, Gilbert, AZ 85234-2165 | 2016-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710500962 | Fatima Health LLC | Nurse Practitioner | 760 North Swallow Lane, Gilbert, AZ 85234 | 2020-05-22 |
| 1073152070 | American Care Concepts Hospice LLC | Hospice Care, Community Based | 765 N. Lindsay Rd., Ste. 208, Gilbert, AZ 85234 | 2019-12-23 |
| 1457918864 | Intuitive Healing Counseling Services, Pllc | Counselor | 3303 E Baseline Rd, Building 5, Suite 109, Gilbert, AZ 85234 | 2019-05-21 |
| 1487123907 | San Tan Behavioral Health Services LLC | Respite Care | 2671 East Vermont Court, Gilbert, AZ 85234 | 2018-11-14 |
| 1770052292 | San Tan Behavioral Health Services | Respite Care | 3970 East Juanita Avenue, Gilbert, AZ 85234 | 2018-11-14 |
| 1891262887 | Victoria Elizabeth Klennertt | Behavior Technician | 3503 E Michelle Way, Gilbert, AZ 85234 | 2018-10-27 |
| 1225503634 | Julia Elizabeth Wiens | Social Worker | 3651 E Baseline Rd Ste 120, Gilbert, AZ 85234 | 2018-10-11 |
| 1295219798 | Raylene Dawn Cargiulo | Registered Nurse | 55 S. Greenfield Rd., Gilbert, AZ 85234 | 2018-09-20 |
| 1346729092 | Katherine M Winegar | Nurse Practitioner | Banner Md Anderson Cancer Center- Administration Office, 2940 E Banner Gateway Drive, Gilbert, AZ 85234 | 2018-08-13 |
| 1881189199 | Desert Valley Oral Surgery | Oral & Maxillofacial Surgery | 2915 E. Baseline Road, Suite 106, Gilbert, AZ 85234 | 2018-06-28 |
| Find all providers in zip 85234 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528667615 | Elena Eloriaga | Nurse Practitioner | 1925 S Coronado Rd Apt 2133, Gilbert, AZ 85295-2219 | 2020-10-20 |
| 1598364838 | Ryan Nelson Sutton | Nurse Practitioner | 3719 E Loma Vista St, Gilbert, AZ 85295-4675 | 2020-10-19 |
| 1518564897 | Erica Odom Mccumbers | Nurse Practitioner | 17 Downing Cir, Gilbert, SC 29054-8483 | 2020-10-08 |
| 1417562844 | Maribeth Kitma Odango | Nurse Practitioner | 3937 E Frances Ln, Gilbert, AZ 85295-2786 | 2020-09-11 |
| 1720698293 | Helene Elizalde | Nurse Practitioner | 1539 E Hummingbird Way, Gilbert, AZ 85297-4601 | 2020-08-08 |
| 1003425273 | Monica Hulsey | Nurse Practitioner | 471 N 159th Pl, Gilbert, AZ 85234-5040 | 2020-07-23 |
| 1801414883 | Scott Braverman | Nurse Practitioner | 225 E Germann Rd Ste 140, Gilbert, AZ 85297-2906 | 2020-07-07 |
| 1467078139 | Racquel Jillian Spyr | Nurse Practitioner | 837 S Parkcrest St, Gilbert, AZ 85296-8839 | 2020-06-18 |
| 1225653074 | Sigma Health and Wellness LLC | Nurse Practitioner | 3317 S. Higley Road, Ste 114-757, Gilbert, AZ 85297 | 2020-06-08 |
| 1710500962 | Fatima Health LLC | Nurse Practitioner | 760 North Swallow Lane, Gilbert, AZ 85234 | 2020-05-22 |
| Find all providers in GILBERT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.