Basic Information
| Provider Information | |||||||||
| NPI: | 1851893192 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WOOD | ||||||||
| FirstName: | ERICKA | ||||||||
| MiddleName: | RENEE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7960 RAFAEL RIVERA WAY UNIT 1358 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891135358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6784149502 | ||||||||
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| Practice Location | |||||||||
| Address1: | 653 N TOWN CENTER DR STE 112 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891440515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027330981 | ||||||||
| FaxNumber: | 7027339751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2018 | ||||||||
| LastUpdateDate: | 07/05/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LN0000X | APRN002819 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal | 163WN0002X | RN95877 | NV | N | Nursing Service Providers | Registered Nurse | Neonatal Intensive Care |
No ID Information.