Healthcare Provider Details

I. General information

NPI: 1649135856
Provider Name (Legal Business Name): ERICA THOMAS CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 S FORSYTH AVE
MC RAE HELENA GA
31037-3862
US

IV. Provider business mailing address

14 S EASTMAN AVE
MC RAE HELENA GA
31037-3843
US

V. Phone/Fax

Practice location:
  • Phone: 229-270-9800
  • Fax: 478-478-8008
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberCN0030012150
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: