Provider Demographics
NPI:1588081897
Name:LOTT, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:LOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7461 BLACKMON RD
Mailing Address - Street 2:APT 4910
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-8400
Mailing Address - Country:US
Mailing Address - Phone:229-395-2073
Mailing Address - Fax:
Practice Address - Street 1:7461 BLACKMON RD
Practice Address - Street 2:APT 4910
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-8400
Practice Address - Country:US
Practice Address - Phone:229-395-2073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN165962163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse