Provider Demographics
NPI:1346539335
Name:STUBBS, ERIKA CHARISE (RN)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:CHARISE
Last Name:STUBBS
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 1:4258 LINECREST LN
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-6901
Mailing Address - Country:US
Mailing Address - Phone:678-887-0645
Mailing Address - Fax:404-244-3603
Practice Address - Street 1:4798 FLAT SHOALS PKWY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-5205
Practice Address - Country:US
Practice Address - Phone:770-808-7788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN 137244163W00000X, 163WC1600X, 163WE0900X, 163WS0200X, 163WW0000X, 163WX1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163W00000XNursing Service ProvidersRegistered Nurse
No163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care