Blalock, Erica Danielle
Blalock, Erica Danielle is an individual health care provider with primary practice located at 1359 Old Water Works Rd Sw , Fort Payne AL 35968-3347. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Blalock, Erica Danielle can be contacted via phone (256) 997-5900.Contact Information
Primary practice address
1359 Old Water Works Rd Sw
Fort Payne AL 35968-3347
Phone: (256) 997-5900
Fax: (256) 997-5995
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 1131087 | Alabama |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 19028 | Tennessee |
Profile Details
| NPI number | 1881095073 |
|---|---|
| LBN Legal business name | Blalock, Erica Danielle |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 8th, 2014 |
| Last updated | Mar 31st, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881095073 | NPPES |
| Alabama | MEDICAID | 179228 | |
| Alabama | Other | 1-131087 |
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