Provider Demographics
NPI:1013925429
Name:BURG, ERICA (ACNP)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:BURG
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:STUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP
Mailing Address - Street 1:PO BOX 10597
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78766-1597
Mailing Address - Country:US
Mailing Address - Phone:512-485-5889
Mailing Address - Fax:512-420-0397
Practice Address - Street 1:1015 E 32ND ST
Practice Address - Street 2:SUITE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2707
Practice Address - Country:US
Practice Address - Phone:512-469-9966
Practice Address - Fax:512-469-9482
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132781363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX559216YQYYMedicare PIN
TX559216ZWM0Medicare PIN
OR500611575Medicaid
Q49609Medicare UPIN