Provider Demographics
NPI:1679184667
Name:GILKERSON, ERICA ROSE (FNP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:ROSE
Last Name:GILKERSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 FAIRFIELD AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:KY
Mailing Address - Zip Code:41073-1072
Mailing Address - Country:US
Mailing Address - Phone:859-379-0240
Mailing Address - Fax:
Practice Address - Street 1:119 FAIRFIELD AVE STE 6
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:KY
Practice Address - Zip Code:41073-1072
Practice Address - Country:US
Practice Address - Phone:859-379-0240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0028450363LF0000X
OH447710390200000X
KY3016074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program