Provider Demographics
NPI:1932616356
Name:BLACK, ERIKA LYNN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:LYNN
Last Name:BLACK
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 1:516 1ST ST
Mailing Address - Street 2:
Mailing Address - City:EYNON
Mailing Address - State:PA
Mailing Address - Zip Code:18403-1437
Mailing Address - Country:US
Mailing Address - Phone:570-313-0006
Mailing Address - Fax:
Practice Address - Street 1:103 SPRUCE ST STE 201
Practice Address - Street 2:
Practice Address - City:HAWLEY
Practice Address - State:PA
Practice Address - Zip Code:18428-1149
Practice Address - Country:US
Practice Address - Phone:570-390-4545
Practice Address - Fax:570-390-4546
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018451363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily