Provider Demographics
NPI:1770035040
Name:SPAULDING, ERIKA (APRN)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:SPAULDING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-654-2283
Mailing Address - Fax:859-654-2284
Practice Address - Street 1:79 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:KY
Practice Address - Zip Code:41006-8704
Practice Address - Country:US
Practice Address - Phone:859-654-2283
Practice Address - Fax:859-654-2284
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010851363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100440940Medicaid