Provider Demographics
NPI:1821536897
Name:EGGMAN, ERICA LYNNE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:LYNNE
Last Name:EGGMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3677 W CAMINO CHRISTY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-8767
Mailing Address - Country:US
Mailing Address - Phone:520-490-4177
Mailing Address - Fax:
Practice Address - Street 1:7468 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2306
Practice Address - Country:US
Practice Address - Phone:520-490-4177
Practice Address - Fax:520-297-9633
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9869363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZF1216069OtherAMERICAN ASSOCIATION OF NURSE PRACTITIONERS
AZAP9869OtherARIZONA STATE BOARD OF NURSING