Healthcare Provider Details

I. General information

NPI: 1982189460
Provider Name (Legal Business Name): ERICA LORRINE SEGERS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2018
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14135 BALLANTYNE CORPORATE PL STE 160
CHARLOTTE NC
28277-4221
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 704-316-5000
  • Fax: 704-316-5010
Mailing address:
  • Phone: 704-316-5000
  • Fax: 704-316-5010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5011142
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5011142
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: