Provider Demographics
NPI:1891137584
Name:SMALL, ERICKA (ARNP)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:SMALL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18980 N MEMORIAL DR STE 330
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4498
Mailing Address - Country:US
Mailing Address - Phone:281-318-2515
Mailing Address - Fax:281-318-2516
Practice Address - Street 1:18980 N MEMORIAL DR STE 330
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4498
Practice Address - Country:US
Practice Address - Phone:281-318-2515
Practice Address - Fax:281-318-2516
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9246855363L00000X, 363LF0000X
TX1094539363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009261300Medicaid
FLHL751ZMedicare PIN