Healthcare Provider Details

I. General information

NPI: 1194264309
Provider Name (Legal Business Name): ERICA VINSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERICA MASON RN

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8402 HARCOURT RD STE 830
INDIANAPOLIS IN
46260-2096
US

IV. Provider business mailing address

10845 GRIFFITH PEAK DR # 2
LAS VEGAS NV
89135-1553
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-8857
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71006893A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: