Provider Demographics
NPI:1205198066
Name:GHASTER, ERICA (RN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:GHASTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 11TH LN
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3556
Mailing Address - Country:US
Mailing Address - Phone:561-644-8470
Mailing Address - Fax:
Practice Address - Street 1:1109 11TH LN
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3556
Practice Address - Country:US
Practice Address - Phone:561-644-8470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9220979163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency