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General NPI Number Information
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NPI Number | 1245869585
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Entity Type | Individual
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Provider Name | ERICA NAGRA RN, BSN
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Gender | Female
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 319 W DELAWARE ST
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City | DECATUR
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State | MI
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Zip | 49045-1106
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Country | US
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Telephone | 269-423-7686
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Fax | 269-423-8282
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Provider Business Mailing Address
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Address Line | 5411 SAQUARO TRL
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City | KALAMAZOO
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State | MI
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Zip | 49009-6414
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Country | US
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Telephone | 269-271-3239
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 4704238589
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License Number State | MI
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