Provider Demographics
NPI:1376506857
Name:HERRMANN, ERIKA BRIGITTE (FNP)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:BRIGITTE
Last Name:HERRMANN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1601
Mailing Address - Street 2:
Mailing Address - City:BLUE JAY
Mailing Address - State:CA
Mailing Address - Zip Code:92317
Mailing Address - Country:US
Mailing Address - Phone:951-312-9312
Mailing Address - Fax:909-337-3741
Practice Address - Street 1:29099 HOSPITAL RD
Practice Address - Street 2:#200
Practice Address - City:LAKE ARROWHEAD
Practice Address - State:CA
Practice Address - Zip Code:92352
Practice Address - Country:US
Practice Address - Phone:909-336-9715
Practice Address - Fax:909-336-5751
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANPRN484024367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered