Provider Demographics
NPI: | 1497093165 |
---|---|
Name: | HALL, ERIKA (APRN-C) |
Entity Type: | Individual |
Prefix: | |
First Name: | ERIKA |
Middle Name: | |
Last Name: | HALL |
Suffix: | |
Gender: | F |
Credentials: | APRN-C |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 5470 E BUSCH BLVD STE 461 |
Mailing Address - Street 2: | |
Mailing Address - City: | TEMPLE TERRACE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33617-5418 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 7402 N 56TH ST STE 100E |
Practice Address - Street 2: | |
Practice Address - City: | TAMPA |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33617-7746 |
Practice Address - Country: | US |
Practice Address - Phone: | 813-710-9555 |
Practice Address - Fax: | 813-710-9556 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2013-01-30 |
Last Update Date: | 2021-10-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | APRN9296866 | 363L00000X, 363LA2200X, 363LP2300X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LP2300X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |