Provider Demographics
NPI:1962019448
Name:HEGRAT, ERICKA (NP)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:HEGRAT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:789 DENNISON AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-1391
Mailing Address - Country:US
Mailing Address - Phone:440-665-1743
Mailing Address - Fax:
Practice Address - Street 1:40 W GAY ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2811
Practice Address - Country:US
Practice Address - Phone:440-665-1743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027574363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner