Provider Demographics
NPI:1336757343
Name:MITCHELL, ERIKA S
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:S
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 FABER PLACE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-8587
Mailing Address - Country:US
Mailing Address - Phone:843-906-0168
Mailing Address - Fax:
Practice Address - Street 1:5037 GOVAN RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:SC
Practice Address - Zip Code:29449-6130
Practice Address - Country:US
Practice Address - Phone:843-906-0168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCIHCP-0853253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care