Provider Demographics
NPI:1255610598
Name:CROSS, ERICA ENGER (PA)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:ENGER
Last Name:CROSS
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:6008 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-2269
Mailing Address - Country:US
Mailing Address - Phone:228-215-0669
Mailing Address - Fax:228-215-0669
Practice Address - Street 1:5935 WASHINGTON AVE STE A
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-2642
Practice Address - Country:US
Practice Address - Phone:228-215-0669
Practice Address - Fax:228-215-0669
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2015-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MSPA00189363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant