MEDICARE: ERICA OZIER 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	163W00000X	Registered Nurse	041402014	IL
2	363L00000X	Nurse Practitioner	209031547	IL
3	363LG0600X	Gerontology Nurse Practitioner	209031547	IL

General Provider Information

NPI Number	:	1700607603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA OZIER APRN

Provider Business Mailing Address
First Line	:	101 COLES CENTRE DR # 100
Second Line	:
City	:	MATTOON
State	:	IL
Zip	:	61938-9314
Country	:	US
Telephone Number	:	217-234-5110
Fax Number	:	217-235-5330

Provider Business Practice Location Address
First Line	:	101 COLES CENTRE DR # 100
Second Line	:
City	:	MATTOON
State	:	IL
Zip	:	61938-9314
Country	:	US
Telephone Number	:	217-234-5110
Fax Number	:	217-235-5330

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

Provider Enumeration Date	:	10/23/2024
Last Update Date	:	02/14/2025

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Directions to “ ERICA OZIER APRN” Practice Location

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