=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184032427
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIKA NICOLE WARD ANP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/30/2014
-----------------------------------------------------
Last Update Date | 06/28/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6015 WATT AVE STE 2
-----------------------------------------------------
City | NORTH HIGHLANDS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95660
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-737-5555
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6015 WATT AVE STE 2
-----------------------------------------------------
City | NORTH HIGHLANDS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95660-4294
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-737-5555
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | ARNP9312270
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | 209013704
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number | 95009175
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------