Provider Demographics
NPI:1245869585
Name:NAGRA, ERICA (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:NAGRA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5411 SAQUARO TRL
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-6414
Mailing Address - Country:US
Mailing Address - Phone:269-271-3239
Mailing Address - Fax:
Practice Address - Street 1:319 W DELAWARE ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:MI
Practice Address - Zip Code:49045-1106
Practice Address - Country:US
Practice Address - Phone:269-423-7686
Practice Address - Fax:269-423-8282
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704238589163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care