Provider Demographics
NPI:1689309502
Name:OSWALT, ERICA LEIGH (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LEIGH
Last Name:OSWALT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:LEIGH
Other - Last Name:BIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7338 THORN BRUSH WAY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-4515
Mailing Address - Country:US
Mailing Address - Phone:575-218-9082
Mailing Address - Fax:
Practice Address - Street 1:5475 TECH CENTER DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-2335
Practice Address - Country:US
Practice Address - Phone:719-212-1636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-24
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004259-C-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily