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General NPI Number Information
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NPI Number | 1396458949
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Entity Type | Individual
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Provider Name | ERICA BLAIR NICHOLAS NP
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Gender | Female
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Dates
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Enumeration Date | 12/28/2022
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 7600 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77054-1906
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Country | US
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Telephone | 713-790-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 8911 DURHAM MANOR LN
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City | HOUSTON
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State | TX
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Zip | 77075-4847
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Country | US
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Telephone | 601-291-9503
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 1096029
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 1096029
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License Number State | TX
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