Provider Demographics
NPI:1447985858
Name:CHAVERS, ERICA D (PHCP011274)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:D
Last Name:CHAVERS
Suffix:
Gender:F
Credentials:PHCP011274
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 SCENIC HWY S
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-3115
Mailing Address - Country:US
Mailing Address - Phone:404-946-5150
Mailing Address - Fax:404-946-5150
Practice Address - Street 1:2330 SCENIC HWY S
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3115
Practice Address - Country:US
Practice Address - Phone:404-946-5150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2024-01-29
Deactivation Date:2022-09-23
Deactivation Code:
Reactivation Date:2022-10-06
Provider Licenses
StateLicense IDTaxonomies
372600000X, 376K00000X, 251J00000X, 376J00000X, 376K00000X, 251E00000X
GA374U00000X, 372600000X, 376J00000X, 376K00000X, 385H00000X
GAPHCP011274253Z00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No376J00000XNursing Service Related ProvidersHomemaker
No385H00000XRespite Care FacilityRespite Care
No251E00000XAgenciesHome Health