Provider Demographics
NPI:1063107613
Name:WILLIAMS, ERICKA HASELDEN (FNP-C)
Entity type:Individual
Prefix:MS
First Name:ERICKA
Middle Name:HASELDEN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 CLOVERFIELD LN
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-5359
Mailing Address - Country:US
Mailing Address - Phone:843-855-1846
Mailing Address - Fax:
Practice Address - Street 1:4710 OLEANDER DR STE 100
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5898
Practice Address - Country:US
Practice Address - Phone:843-839-1935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26998363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily