Provider Demographics
NPI:1225549595
Name:CANOUSE, ERIKA LOUISE (PA-C)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:LOUISE
Last Name:CANOUSE
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:LOUISE
Other - Last Name:ORTEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:956 ISABEL DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7482
Practice Address - Country:US
Practice Address - Phone:717-639-3640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110006664363A00000X, 363AM0700X, 363AS0400X
PAMO4553966363AM0700X
PAMA059375363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical