Provider Demographics
NPI:1790079481
Name:SCHELL, ERICA NICHOLE (APRN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:NICHOLE
Last Name:SCHELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:NICHOLE
Other - Last Name:CUMMINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2309
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42702-2309
Mailing Address - Country:US
Mailing Address - Phone:270-706-1111
Mailing Address - Fax:270-706-1682
Practice Address - Street 1:1111 RING RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-4900
Practice Address - Country:US
Practice Address - Phone:270-706-1111
Practice Address - Fax:270-706-1682
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006925363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100169190Medicaid
K018870Medicare PIN