Provider Demographics
NPI:1902342322
Name:LEE, ERICA TRAVONYA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:TRAVONYA
Last Name:LEE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:ERICA
Other - Middle Name:TRAVONYA
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:2334 MILAN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-6258
Mailing Address - Country:US
Mailing Address - Phone:504-909-9292
Mailing Address - Fax:
Practice Address - Street 1:131 S ROBERTSON ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2807
Practice Address - Country:US
Practice Address - Phone:504-988-3524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09105363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner