MEDICARE: ERICA HABERLAND

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	231H00000X	Audiologist	15320	NC

General Provider Information

NPI Number	:	1306593363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA HABERLAND

Provider Business Mailing Address
First Line	:	824 GUM BRANCH RD
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-6272
Country	:	US
Telephone Number	:	910-353-4327
Fax Number	:

Provider Business Practice Location Address
First Line	:	824 GUM BRANCH RD
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-6272
Country	:	US
Telephone Number	:	910-353-4327
Fax Number	:

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

Provider Enumeration Date	:	03/09/2022
Last Update Date	:	12/08/2025

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