Provider Demographics
NPI:1780261867
Name:AUSTIN, ERICKA (NP-C)
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:AUSTIN
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 1:661 S PARKWAY E
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38106-5617
Mailing Address - Country:US
Mailing Address - Phone:901-942-1543
Mailing Address - Fax:
Practice Address - Street 1:661 S PARKWAY E
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38106-5617
Practice Address - Country:US
Practice Address - Phone:901-942-1543
Practice Address - Fax:901-948-2241
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNF01210069207V00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology