Provider Demographics
NPI:1477987402
Name:PIERRE, ERICKA DENISE (NP)
Entity Type:Individual
Prefix:MS
First Name:ERICKA
Middle Name:DENISE
Last Name:PIERRE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 HIDDEN RDG
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3813
Mailing Address - Country:US
Mailing Address - Phone:469-282-2711
Mailing Address - Fax:469-282-0996
Practice Address - Street 1:1460 E BERT KOUNS INDUSTRIAL LOOP
Practice Address - Street 2:SUITE 700
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5644
Practice Address - Country:US
Practice Address - Phone:318-681-5580
Practice Address - Fax:318-681-5280
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07428363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2349783Medicaid
LA328822YJBAMedicare PIN