Provider Demographics
NPI:1497409882
Name:HORACE, ERICA MONIQUE (FNP-C)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:MONIQUE
Last Name:HORACE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5338 KNIGHTS LNDG
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-1596
Mailing Address - Country:US
Mailing Address - Phone:865-661-5741
Mailing Address - Fax:
Practice Address - Street 1:6781 LONDONDERRY WAY STE 5
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-2094
Practice Address - Country:US
Practice Address - Phone:770-731-2933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-05
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN267769363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily