Provider Demographics
NPI:1942025390
Name:JUNE, ERICKA SHANTA
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:SHANTA
Last Name:JUNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1191 ARKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-2005
Mailing Address - Country:US
Mailing Address - Phone:614-516-1620
Mailing Address - Fax:
Practice Address - Street 1:1191 ARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-2005
Practice Address - Country:US
Practice Address - Phone:614-516-1620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0096757374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide