Provider Demographics
NPI:1437608809
Name:OCHOA, ERICA L (APRN)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:L
Last Name:OCHOA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:L
Other - Last Name:BLANCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1207 CREWS RD STE E
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-7582
Mailing Address - Country:US
Mailing Address - Phone:704-841-8162
Mailing Address - Fax:
Practice Address - Street 1:1207 CREWS RD STE E
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-7582
Practice Address - Country:US
Practice Address - Phone:704-841-8162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9363994363LF0000X
NC5021505363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021844100Medicaid