Provider Demographics
NPI:1427804020
Name:POLOWAY, ERIKA LYNN (NP-C)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:LYNN
Last Name:POLOWAY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 JOANN DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-9275
Mailing Address - Country:US
Mailing Address - Phone:904-962-6699
Mailing Address - Fax:
Practice Address - Street 1:2215 JOANN DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-9275
Practice Address - Country:US
Practice Address - Phone:904-962-6699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008671363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner