Provider Demographics
NPI:1568842920
Name:HENRICKS, ERICA RAE BRIGHT (ARNP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:RAE BRIGHT
Last Name:HENRICKS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:RAE
Other - Last Name:BRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1215 DUFF AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-5400
Mailing Address - Country:US
Mailing Address - Phone:515-239-4431
Mailing Address - Fax:515-239-4742
Practice Address - Street 1:1215 DUFF AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-5400
Practice Address - Country:US
Practice Address - Phone:515-239-4431
Practice Address - Fax:515-239-4742
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH120383363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner