Provider Demographics
NPI:1003583790
Name:ERIKA'S STUDIO LOFT, LLC
Entity Type:Organization
Organization Name:ERIKA'S STUDIO LOFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ARTIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-394-0477
Mailing Address - Street 1:2965 CANON CT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6679
Mailing Address - Country:US
Mailing Address - Phone:678-394-0477
Mailing Address - Fax:
Practice Address - Street 1:2635 FREEDOM PKWY STE 10
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-9176
Practice Address - Country:US
Practice Address - Phone:678-394-0477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, MedicalGroup - Multi-Specialty