Provider Demographics
NPI:1497037709
Name:SANKS, ERICA (RN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:SANKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23000 KENOSHA ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2432
Mailing Address - Country:US
Mailing Address - Phone:248-225-9192
Mailing Address - Fax:
Practice Address - Street 1:23000 KENOSHA ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2432
Practice Address - Country:US
Practice Address - Phone:248-225-9192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704272542163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health