Provider Demographics
NPI:1407322373
Name:POYNTZ, ERICA MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:MARIE
Last Name:POYNTZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:MARIE
Other - Last Name:NAGY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:878 EL CAPITAN WAY
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7943
Mailing Address - Country:US
Mailing Address - Phone:805-234-4292
Mailing Address - Fax:
Practice Address - Street 1:1400 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5906
Practice Address - Country:US
Practice Address - Phone:805-332-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010264363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner