Provider Demographics
NPI:1457831893
Name:MCKEVER, ERICA CHANNEL
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:CHANNEL
Last Name:MCKEVER
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 1:3501 PENN DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-3652
Mailing Address - Country:US
Mailing Address - Phone:919-797-7124
Mailing Address - Fax:
Practice Address - Street 1:3501 PENN DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-3652
Practice Address - Country:US
Practice Address - Phone:919-797-7124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)