Provider Demographics
NPI:1184108847
Name:KINDS, ERICIA SHANTE (RN)
Entity type:Individual
Prefix:
First Name:ERICIA
Middle Name:SHANTE
Last Name:KINDS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ERICIA
Other - Middle Name:SHANTE
Other - Last Name:TYLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2025 VALLEY FALLS AVE
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-2111
Mailing Address - Country:US
Mailing Address - Phone:214-998-3002
Mailing Address - Fax:
Practice Address - Street 1:2025 VALLEY FALLS AVE
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-2111
Practice Address - Country:US
Practice Address - Phone:601-870-9470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX851312163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse