Provider Demographics
NPI:1932948445
Name:HAIGOOD, ERICA JEAN (RN)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:JEAN
Last Name:HAIGOOD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:JEAN
Other - Last Name:ALBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:117 WATERVIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2857
Mailing Address - Country:US
Mailing Address - Phone:830-515-5193
Mailing Address - Fax:
Practice Address - Street 1:117 WATERVIEW PKWY
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2857
Practice Address - Country:US
Practice Address - Phone:830-515-5193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1875208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery