Provider Demographics
NPI:1164076170
Name:WITKONIS, ERICA MARIE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:MARIE
Last Name:WITKONIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:MARIE
Other - Last Name:LEHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1650 CROOKED OAK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4278
Mailing Address - Country:US
Mailing Address - Phone:717-569-3279
Mailing Address - Fax:
Practice Address - Street 1:1650 CROOKED OAK DR STE 200
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4278
Practice Address - Country:US
Practice Address - Phone:717-569-3279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020558363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner