Provider Demographics
NPI:1568060911
Name:PARENTE, ERICA J (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:J
Last Name:PARENTE
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:MRS
Other - First Name:ERICA
Other - Middle Name:J
Other - Last Name:SEVERSON-PARENTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPHT
Mailing Address - Street 1:1001 CUSTER LN
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:KS
Mailing Address - Zip Code:67010-9511
Mailing Address - Country:US
Mailing Address - Phone:316-680-5130
Mailing Address - Fax:316-775-2289
Practice Address - Street 1:509 STATE ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:KS
Practice Address - Zip Code:67010-1107
Practice Address - Country:US
Practice Address - Phone:316-775-2289
Practice Address - Fax:316-775-2280
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-10655183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician