Provider Demographics
NPI:1366855413
Name:FIEDLER, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:FIEDLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 E REDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-3234
Mailing Address - Country:US
Mailing Address - Phone:773-727-8481
Mailing Address - Fax:
Practice Address - Street 1:6301 E REDFIELD RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3234
Practice Address - Country:US
Practice Address - Phone:773-727-8481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018101183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist