Provider Demographics
NPI:1508312539
Name:SPERDUTO, ERICA ANN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:ANN
Last Name:SPERDUTO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:ANN
Other - Last Name:HUGHEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1101 NOR TEC DRIVE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013
Mailing Address - Country:US
Mailing Address - Phone:678-374-7514
Mailing Address - Fax:678-374-7517
Practice Address - Street 1:1101 NOR TEC DRIVE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013
Practice Address - Country:US
Practice Address - Phone:678-374-7514
Practice Address - Fax:678-374-7517
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN261374363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily