Provider Demographics
NPI:1689193088
Name:JONES, ERICCA LASHAE (APRN, FNP)
Entity Type:Individual
Prefix:
First Name:ERICCA
Middle Name:LASHAE
Last Name:JONES
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:ERICCA
Other - Middle Name:LASHAE
Other - Last Name:CALDWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3884 E GARDEN MANOR DR APT 103
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-6549
Mailing Address - Country:US
Mailing Address - Phone:903-571-2148
Mailing Address - Fax:
Practice Address - Street 1:877 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-2807
Practice Address - Country:US
Practice Address - Phone:901-545-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-17
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135115363LP2300X
TN23497363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care