Provider Demographics
NPI:1619454188
Name:THOMASON, ERICA R (NP)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:R
Last Name:THOMASON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 MAXWELL AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-4359
Mailing Address - Country:US
Mailing Address - Phone:812-746-0098
Mailing Address - Fax:812-671-0627
Practice Address - Street 1:2015 MAXWELL AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-4359
Practice Address - Country:US
Practice Address - Phone:812-746-0098
Practice Address - Fax:812-671-0627
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28197047A363L00000X
IN71008258A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner