Provider Demographics
NPI:1316700610
Name:CRITTENDON, ERICA NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:NICOLE
Last Name:CRITTENDON
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 1:10027 E 100 N
Mailing Address - Street 2:
Mailing Address - City:KNOX
Mailing Address - State:IN
Mailing Address - Zip Code:46534-8870
Mailing Address - Country:US
Mailing Address - Phone:219-707-6034
Mailing Address - Fax:
Practice Address - Street 1:5501 S 1100 W
Practice Address - Street 2:
Practice Address - City:WESTVILLE
Practice Address - State:IN
Practice Address - Zip Code:46391-9335
Practice Address - Country:US
Practice Address - Phone:219-707-6034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INF12230314363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily