Provider Demographics
NPI:1447878129
Name:HERING, ERICKA NICOLE (APRN)
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:NICOLE
Last Name:HERING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ERICKA
Other - Middle Name:NICOLE
Other - Last Name:HERING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1301 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-2298
Mailing Address - Country:US
Mailing Address - Phone:727-584-7706
Mailing Address - Fax:727-586-6018
Practice Address - Street 1:1301 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-2298
Practice Address - Country:US
Practice Address - Phone:727-584-7706
Practice Address - Fax:727-586-6018
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11007948363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107876900Medicaid
FLUCLAOOtherBCBS