Provider Demographics
NPI:1467215020
Name:HALL, ERICA YUNEKA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:YUNEKA
Last Name:HALL
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 1:884 GLADIOLA CIR APT 123
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-6244
Mailing Address - Country:US
Mailing Address - Phone:321-914-7506
Mailing Address - Fax:
Practice Address - Street 1:884 GLADIOLA CIR APT 123
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-6244
Practice Address - Country:US
Practice Address - Phone:321-914-7506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA253722376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide