Healthcare Provider Details

I. General information

NPI: 1881494136
Provider Name (Legal Business Name): ERIKA NICHOLE ORUE-CONN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 PARK PL
MISHAWAKA IN
46545-3519
US

IV. Provider business mailing address

29274 MONTAUK LN
ELKHART IN
46517-8574
US

V. Phone/Fax

Practice location:
  • Phone: 574-273-6767
  • Fax: 574-273-6757
Mailing address:
  • Phone: 574-849-6949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71016431A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: