Provider Demographics
NPI:1225812969
Name:FLEURY, ERICA (PMHNP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:FLEURY
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WHITE BLUFF
Mailing Address - State:TN
Mailing Address - Zip Code:37187-9154
Mailing Address - Country:US
Mailing Address - Phone:330-612-8870
Mailing Address - Fax:
Practice Address - Street 1:308 W 15TH ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-2038
Practice Address - Country:US
Practice Address - Phone:270-660-8866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4015713363LP0808X
TN234746163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health