Provider Demographics
NPI:1598298028
Name:STANLEY, ERICA K (APRN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:K
Last Name:STANLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:RAIKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3086 STATE ROUTE 160
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-8409
Mailing Address - Country:US
Mailing Address - Phone:740-446-5500
Mailing Address - Fax:740-446-4951
Practice Address - Street 1:3086 STATE ROUTE 160
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631
Practice Address - Country:US
Practice Address - Phone:740-446-5500
Practice Address - Fax:740-446-4951
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021334363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health