Provider Demographics
NPI:1457904419
Name:RAGAN, ERIKA (CRNP)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:RAGAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 KITTERING CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-5908
Mailing Address - Country:US
Mailing Address - Phone:850-591-2918
Mailing Address - Fax:
Practice Address - Street 1:7801 YORK RD STE 102
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7447
Practice Address - Country:US
Practice Address - Phone:410-769-4920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR185449363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner