Provider Demographics
NPI:1255903597
Name:WALTON, ERICA LYNN (NP)
Entity type:Individual
Prefix:PROF
First Name:ERICA
Middle Name:LYNN
Last Name:WALTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1514 SHERIDAN RD NE APT 2416
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-5470
Mailing Address - Country:US
Mailing Address - Phone:478-250-4048
Mailing Address - Fax:
Practice Address - Street 1:3543 HIGHWAY 81 # 201
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-4336
Practice Address - Country:US
Practice Address - Phone:678-615-2382
Practice Address - Fax:770-674-0250
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN250356363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner