Provider Demographics
NPI:1295250637
Name:ROBERSON, ERICA K
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:K
Last Name:ROBERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:K
Other - Last Name:ROBERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CONTRACTOR
Mailing Address - Street 1:3402 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-7434
Mailing Address - Country:US
Mailing Address - Phone:804-898-1010
Mailing Address - Fax:
Practice Address - Street 1:3402 SOUTH ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-7434
Practice Address - Country:US
Practice Address - Phone:804-898-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor