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General NPI Number Information
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NPI Number | 1801272828
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Entity Type | Individual
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Provider Name | ERICA MAZZAFERRI
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Gender | Female
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Dates
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Enumeration Date | 07/31/2015
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 1650 COCHRANE CIR
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City | FORT CARSON
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State | CO
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Zip | 80913-4604
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Country | US
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Telephone | 719-526-6073
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Fax |
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Provider Business Mailing Address
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Address Line | 542 CREEKSIDE CT
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City | MONROE
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State | OH
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Zip | 45050-2116
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Country | US
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Telephone | 513-310-4848
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PHA.0020744
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License Number State | CO
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