Provider Demographics
NPI:1649864034
Name:PRESTON, ERICA RENEE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:RENEE
Last Name:PRESTON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W PLUMMER ST
Mailing Address - Street 2:
Mailing Address - City:EASTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:76448-2627
Mailing Address - Country:US
Mailing Address - Phone:254-629-1744
Mailing Address - Fax:254-629-3904
Practice Address - Street 1:1712 N ACCESS RD
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:TX
Practice Address - Zip Code:79510-3352
Practice Address - Country:US
Practice Address - Phone:325-893-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1030957363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily