Provider Demographics
NPI:1699953166
Name:DICE, ERIN S (PA C)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:S
Last Name:DICE
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-5070
Mailing Address - Fax:704-316-5075
Practice Address - Street 1:9604 HOLLY POINT DR
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-4913
Practice Address - Country:US
Practice Address - Phone:704-316-5070
Practice Address - Fax:704-316-5075
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0100 01042363AM0700X
NC0010-01042363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical