Provider Demographics
NPI:1053653998
Name:ERICHSEN, MAYVELYN YOSALINA (APN)
Entity type:Individual
Prefix:
First Name:MAYVELYN
Middle Name:YOSALINA
Last Name:ERICHSEN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:MAYVELYN
Other - Middle Name:DUMAGAT
Other - Last Name:YOSALINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 511360
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-7915
Mailing Address - Country:US
Mailing Address - Phone:775-398-1981
Mailing Address - Fax:775-398-1984
Practice Address - Street 1:781 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1320
Practice Address - Country:US
Practice Address - Phone:775-398-1981
Practice Address - Fax:775-398-1984
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001501363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily