Micou, Ericka M

Micou, Ericka M is an individual health care provider with primary practice located at 1134 Winter St , Jackson MS 39204-2841. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Community Health, which is considered as her primary health care specialty. Micou, Ericka M can be contacted via phone (601) 948-5572.

Contact Information

Primary practice address
1134 Winter St Jackson MS 39204-2841
Phone: (601) 948-5572
Fax: (601) 914-3012
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Community Health 363LC1500X 363L00000X Mississippi

Profile Details

NPI number 1568598027
LBN Legal business name Micou, Ericka M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 26th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568598027 NPPES
Mississippi MEDICAID 07450365

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