Healthcare Provider Details

I. General information

NPI: 1174163356
Provider Name (Legal Business Name): ERIKA NICHOLE ADAMS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 07/22/2021
Certification Date: 07/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 FORD RD.
JOHN DAY OR
97845
US

IV. Provider business mailing address

30339 N RIVER RD
PRAIRIE CITY OR
97869
US

V. Phone/Fax

Practice location:
  • Phone: 541-575-0404
  • Fax:
Mailing address:
  • Phone: 360-319-8426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number202000441NP-PP
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number202000441NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: