Provider Demographics
NPI:1609160811
Name:FEDORS, ERIKA L (APN)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:L
Last Name:FEDORS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:750 E ADAMS ST
Mailing Address - Street 2:SUITE 8801
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2306
Mailing Address - Country:US
Mailing Address - Phone:315-464-6241
Mailing Address - Fax:315-464-6238
Practice Address - Street 1:750 E ADAMS ST
Practice Address - Street 2:SUITE 8801
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2306
Practice Address - Country:US
Practice Address - Phone:315-464-6241
Practice Address - Fax:315-464-6238
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209008736363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care