MEDICARE: ERIS BILL MS, RN, AGACNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	0024173672	VA

General Provider Information

NPI Number	:	1548611940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIS BILL MS, RN, AGACNP-BC

Provider Business Mailing Address
First Line	:	2235 STAPLES MILL RD STE 100
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-2942
Country	:	US
Telephone Number	:	804-281-0451
Fax Number	:

Provider Business Practice Location Address
First Line	:	2235 STAPLES MILL RD STE 100
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-2942
Country	:	US
Telephone Number	:	804-281-0451
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2016
Last Update Date	:	10/30/2019

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