Healthcare Provider Details

I. General information

NPI: 1962019448
Provider Name (Legal Business Name): ERICKA HEGRAT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2020
Last Update Date: 09/28/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 W GAY ST
COLUMBUS OH
43215-2811
US

IV. Provider business mailing address

789 DENNISON AVE APT 306
COLUMBUS OH
43215-1391
US

V. Phone/Fax

Practice location:
  • Phone: 440-665-1743
  • Fax:
Mailing address:
  • Phone: 440-665-1743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0027574
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: