Provider Demographics
NPI:1316364730
Name:FERNANDEZ, ERIKA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:MARIE
Last Name:FERNANDEZ
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 1:87 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3873
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:360 BROCKTON AVE STE 102
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:MA
Practice Address - Zip Code:02351-2186
Practice Address - Country:US
Practice Address - Phone:781-792-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-24
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2291744163W00000X
MAMF1075642N363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse