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General NPI Number Information
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NPI Number | 1598649246
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Entity Type | Individual
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Provider Name | ERICA JANELLE WAIT PMHNP
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Gender | Female
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 401 WOODLAND HILLS BLVD
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City | FORT SCOTT
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State | KS
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Zip | 66701-8797
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Country | US
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Telephone | 417-296-6713
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Fax |
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Provider Business Mailing Address
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Address Line | 401 WOODLAND HILLS BLVD
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City | FORT SCOTT
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State | KS
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Zip | 66701-8797
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Country | US
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Telephone | 620-644-1195
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 53-84618-031
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2025026816
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License Number State | MO
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