Provider Demographics
NPI:1720805096
Name:GILKERSON, ERIKA
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:GILKERSON
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 1:589 W HIGHWAY 92
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40769-1684
Mailing Address - Country:US
Mailing Address - Phone:606-549-8611
Mailing Address - Fax:606-549-8347
Practice Address - Street 1:589 W HIGHWAY 92
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:KY
Practice Address - Zip Code:40769-1684
Practice Address - Country:US
Practice Address - Phone:606-549-8611
Practice Address - Fax:606-549-8347
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY279712156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician