Provider Demographics
NPI:1982155321
Name:MCPHEE, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:MCPHEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-6831
Mailing Address - Country:US
Mailing Address - Phone:989-894-4591
Mailing Address - Fax:989-895-4620
Practice Address - Street 1:1900 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708
Practice Address - Country:US
Practice Address - Phone:989-894-4591
Practice Address - Fax:989-895-4620
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704282770363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI1566010OtherMEDICARE PTAN