Provider Demographics
NPI:1538404520
Name:DALEK, ERICA BROOKE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:BROOKE
Last Name:DALEK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 HOMESTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6638
Mailing Address - Country:US
Mailing Address - Phone:304-232-1020
Mailing Address - Fax:
Practice Address - Street 1:24 HOMESTEAD AVE
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6638
Practice Address - Country:US
Practice Address - Phone:304-232-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-03
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV73129363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily