=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063172971
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERICA LEIGH PARGMANN PMHNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2021
-----------------------------------------------------
Last Update Date | 12/20/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2601 SCRIPTURE ST STE 102
-----------------------------------------------------
City | DENTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76201-4322
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-442-6455
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 417 NOTTINGHAM CT
-----------------------------------------------------
City | SAGINAW
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76179-0815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 682-319-4077
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 1059910
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------