Provider Demographics
NPI:1144569435
Name:HARRIS, ERIKA M (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:M
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1769 JAMESTOWN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-2310
Mailing Address - Country:US
Mailing Address - Phone:910-850-8636
Mailing Address - Fax:866-432-1706
Practice Address - Street 1:1769 JAMESTOWN RD STE 101
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2310
Practice Address - Country:US
Practice Address - Phone:757-719-9039
Practice Address - Fax:866-432-1706
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110003903207R00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1144569435Medicaid