Provider Demographics
NPI:1659025518
Name:IMAOKA, ERICA (DNP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:IMAOKA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3528 BAY ISLAND CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-3950
Mailing Address - Country:US
Mailing Address - Phone:312-961-5814
Mailing Address - Fax:
Practice Address - Street 1:3528 BAY ISLAND CIR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3950
Practice Address - Country:US
Practice Address - Phone:312-961-5814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife