Provider Demographics
NPI:1881456036
Name:CHAMPION, ERIKA DANIELLE (FNP)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:DANIELLE
Last Name:CHAMPION
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 S MADISONVILLE ST
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:KY
Mailing Address - Zip Code:42217-8009
Mailing Address - Country:US
Mailing Address - Phone:280-220-0240
Mailing Address - Fax:
Practice Address - Street 1:241 S MADISONVILLE ST
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:KY
Practice Address - Zip Code:42217-8009
Practice Address - Country:US
Practice Address - Phone:280-220-0240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4014897363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily