Provider Demographics
NPI:1912469909
Name:HREHA, ERIKA NICOLE (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:NICOLE
Last Name:HREHA
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42002 COULON DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-2228
Mailing Address - Country:US
Mailing Address - Phone:586-873-8408
Mailing Address - Fax:
Practice Address - Street 1:42002 COULON DR
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-2228
Practice Address - Country:US
Practice Address - Phone:586-873-8408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704291789207RC0200X, 163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704291789OtherSTATE OF MICHIGAN NURSING LICENSE- SPECIALTY CERTIFICATION
4704291789OtherRN LICENSE