Provider Demographics
NPI:1811305220
Name:COPPOLA, ERICA (CNM)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:COPPOLA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DUKE HEALTH CARY PL STE 310
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6759
Mailing Address - Country:US
Mailing Address - Phone:973-214-5752
Mailing Address - Fax:
Practice Address - Street 1:100 DUKE HEALTH CARY PL STE 310
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-6759
Practice Address - Country:US
Practice Address - Phone:919-684-2471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201142386RN163W00000X
OR201405097NP-PP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500675286Medicaid
ORR183325OtherMEDICARE PTAN