Healthcare Provider Details
I. General information
NPI: 1881653905
Provider Name (Legal Business Name): ERICA A DEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/18/2006
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
79 ERDMAN WAY SUITE 101
LEOMINSTER MA
01453
US
IV. Provider business mailing address
79 ERDMAN WAY SUITE 101
LEOMINSTER MA
01453
US
V. Phone/Fax
- Phone: 978-537-4805
- Fax: 978-537-2185
- Phone: 978-537-4805
- Fax: 978-537-2185
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | RN233869 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | RN233869 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: