Provider Demographics
NPI:1831514033
Name:BLOCKER, ERICA LYNN (NP-C)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LYNN
Last Name:BLOCKER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:LYNN
Other - Last Name:PORTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:15472 COLUMBIA HWY
Mailing Address - Street 2:
Mailing Address - City:LYNNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38472-5225
Mailing Address - Country:US
Mailing Address - Phone:931-292-3053
Mailing Address - Fax:
Practice Address - Street 1:215 S CEDAR LN
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-3502
Practice Address - Country:US
Practice Address - Phone:931-363-2511
Practice Address - Fax:931-424-6109
Is Sole Proprietor?:No
Enumeration Date:2014-02-25
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18376363LF0000X
TN182415163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse