Healthcare Provider Details

I. General information

NPI: 1639814676
Provider Name (Legal Business Name): ERIKA ESTES RUBANT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 OLD ROSWELL LAKES PKWY
ROSWELL GA
30076-8663
US

IV. Provider business mailing address

900 OLD ROSWELL LAKES PKWY
ROSWELL GA
30076-8663
US

V. Phone/Fax

Practice location:
  • Phone: 888-731-8994
  • Fax:
Mailing address:
  • Phone: 888-731-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN150711
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: