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NPI Code Detail

MEDICARE: ERIKA ELIZABETH PERNELL

MEDICARE: ERIKA ELIZABETH PERNELL
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1306522966
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIKA ELIZABETH PERNELL
Provider Business Mailing Address
First Line : 1111 W MOCKINGBIRD LN STE 480
Second Line :
City : DALLAS
State : TX
Zip : 75247-5062
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1111 W MOCKINGBIRD LN STE 480
Second Line :
City : DALLAS
State : TX
Zip : 75247-5062
Country : US
Telephone Number : 972-373-4842
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2023
Last Update Date : 06/27/2023

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Directions to “ ERIKA ELIZABETH PERNELL ” Practice Location

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