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General NPI Number Information
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NPI Number | 1649864034
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Entity Type | Individual
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Provider Name | ERICA RENEE PRESTON APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 02/25/2021
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 1712 N ACCESS RD
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City | CLYDE
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State | TX
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Zip | 79510-3352
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Country | US
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Telephone | 325-893-4010
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Fax |
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Provider Business Mailing Address
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Address Line | 400 W PLUMMER ST
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City | EASTLAND
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State | TX
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Zip | 76448-2627
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Country | US
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Telephone | 254-629-1744
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Fax | 254-629-3904
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1030957
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License Number State | TX
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