Provider Demographics
NPI:1275844151
Name:DENNIS, ERICA BLANCHE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:BLANCHE
Last Name:DENNIS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636388
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6388
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2222 CHERRY ST STE 2300
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-2675
Practice Address - Country:US
Practice Address - Phone:419-251-8013
Practice Address - Fax:419-251-7760
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-25
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.11562363LF0000X
OHAPRN.CNP.11562363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3106150Medicaid
OHNP36281Medicare PIN