Provider Demographics
NPI:1861077794
Name:GORMAN, ERIKA JANEL (RN)
Entity type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:JANEL
Last Name:GORMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:ERIKA
Other - Middle Name:JANEL
Other - Last Name:MCCREESH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:647 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-6040
Mailing Address - Country:US
Mailing Address - Phone:619-920-6558
Mailing Address - Fax:
Practice Address - Street 1:647 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-6040
Practice Address - Country:US
Practice Address - Phone:619-920-6558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA584113163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse