MEDICARE: ERICA LORRAINE TOLLERSON

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	363L00000X	Nurse Practitioner	31316	SC

General Provider Information

NPI Number	:	1801752696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA LORRAINE TOLLERSON

Provider Business Mailing Address
First Line	:	783 SIENNA WAY
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29486-8311
Country	:	US
Telephone Number	:	843-330-9933
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 COURTENAY DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8911
Country	:	US
Telephone Number	:	843-792-2900
Fax Number	:

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

Provider Enumeration Date	:	12/24/2025
Last Update Date	:	12/24/2025

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Directions to “ ERICA LORRAINE TOLLERSON ” Practice Location

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