Provider Demographics
NPI:1861829327
Name:LURTEN, ERICA NICOLE (AUD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:NICOLE
Last Name:LURTEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 NW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4561
Mailing Address - Country:US
Mailing Address - Phone:479-715-6062
Mailing Address - Fax:479-715-6064
Practice Address - Street 1:906 NW 8TH ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4561
Practice Address - Country:US
Practice Address - Phone:479-715-6062
Practice Address - Fax:479-715-6064
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR374231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist