Provider Demographics
NPI:1689328858
Name:KORNS, ERICA NICOLE (RN)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:NICOLE
Last Name:KORNS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:NICOLE
Other - Last Name:CARL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4338 VISTA LN
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-4419
Mailing Address - Country:US
Mailing Address - Phone:937-397-6319
Mailing Address - Fax:
Practice Address - Street 1:800 PRUDENTIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8202
Practice Address - Country:US
Practice Address - Phone:904-202-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9562038163W00000X
OHRN375227163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse