Basic Information
Provider Information
NPI: 1396973137
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIRCHHILL
FirstName: ERIKA
MiddleName: JAYNE
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: DIERKER
OtherFirstName: ERIKA
OtherMiddleName: JAYNE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PA
OtherLastNameType: 1
Mailing Information
Address1: 1702 UNIVERSITY DR S
Address2:  
City: FARGO
State: ND
PostalCode: 581034940
CountryCode: US
TelephoneNumber: 7013644222
FaxNumber:  
Practice Location
Address1: 400 E 3RD ST
Address2:  
City: DULUTH
State: MN
PostalCode: 558051951
CountryCode: US
TelephoneNumber: 2187868364
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/01/2009
LastUpdateDate: 02/27/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AS0400X12077MNY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical

No ID Information.


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