MEDICARE: MRS. ERICA CLIPPS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11004662	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295352185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERICA CLIPPS APRN

Provider Business Mailing Address
First Line	:	2804 REMINGTON GREEN CIR STE 2
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-1550
Country	:	US
Telephone Number	:	850-385-4494
Fax Number	:

Provider Business Practice Location Address
First Line	:	412 SW HIGHWAY 351
Second Line	:
City	:	CROSS CITY
State	:	FL
Zip	:	32628-3827
Country	:	US
Telephone Number	:	524-983-3493
Fax Number	:	352-498-0716

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2020
Last Update Date	:	07/13/2021

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