Healthcare Provider Details

I. General information

NPI: 1790079481
Provider Name (Legal Business Name): ERICA NICHOLE SCHELL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERICA NICHOLE CUMMINGS

II. Dates (important events)

Enumeration Date: 05/31/2011
Last Update Date: 04/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 RING RD
ELIZABETHTOWN KY
42701-4900
US

IV. Provider business mailing address

PO BOX 2309
ELIZABETHTOWN KY
42702-2309
US

V. Phone/Fax

Practice location:
  • Phone: 270-706-1111
  • Fax: 270-706-1682
Mailing address:
  • Phone: 270-706-1111
  • Fax: 270-706-1682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3006925
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: