Provider Demographics
NPI:1710380878
Name:FORREY, ERIN LUIKART (APRN)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:LUIKART
Last Name:FORREY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:DR
Other - First Name:ERIN
Other - Middle Name:JACQUELYN
Other - Last Name:LUIKART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, ARNP, AGPCNP-C
Mailing Address - Street 1:PO BOX 645743
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-5743
Mailing Address - Country:US
Mailing Address - Phone:855-689-5105
Mailing Address - Fax:904-446-3032
Practice Address - Street 1:2800 E BROAD ST STE 308
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-6412
Practice Address - Country:US
Practice Address - Phone:682-622-4325
Practice Address - Fax:682-622-4322
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9275758363LC1500X, 363LA2200X, 363LW0102X
TXAPRN1035552363LG0600X
FLAPRN9275758363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014102700Medicaid
FLIR274ZMedicare PIN
FL014102700Medicaid
FLIR274XMedicare PIN