Provider Demographics
NPI:1437467453
Name:HERICKS, CHRISTINA VERONICA (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:VERONICA
Last Name:HERICKS
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:VERONICA
Other - Last Name:BOYEAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10701 EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1702
Mailing Address - Country:US
Mailing Address - Phone:216-791-3800
Mailing Address - Fax:216-229-2636
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN333391363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health