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General NPI Number Information
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NPI Number | 1316125024
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Entity Type | Individual
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Provider Name | LAURA ASHLEY ERMENC M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 616 W FOREST AVE
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City | JACKSON
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State | TN
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Zip | 38301-3902
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Country | US
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Telephone | 731-541-7070
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Fax | 731-541-7075
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Provider Business Mailing Address
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Address Line | PO BOX 400
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City | JACKSON
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State | TN
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Zip | 38302-0400
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Country | US
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Telephone | 731-423-8697
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Fax | 731-422-5743
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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 | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 101169
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 46400
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 4834-320
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License Number State | WI
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