Provider Demographics
NPI:1295977411
Name:OLIVER, ERIKA A (NP)
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:A
Last Name:OLIVER
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:PO BOX 3087
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-3087
Mailing Address - Country:US
Mailing Address - Phone:985-230-2630
Mailing Address - Fax:985-230-2634
Practice Address - Street 1:530 W PINE ST STE 1
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-3780
Practice Address - Country:US
Practice Address - Phone:985-370-5656
Practice Address - Fax:985-370-4225
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05754363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAP00766104OtherMEDICARE RR
LA1795267Medicaid
LA256168YJXFMedicare PIN
LAP00766104OtherMEDICARE RR