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Individual
ERICA PONCE-DOUGHERTY
Active
Individual
ERICA PONCE-DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1508649310
OK
363AM0700X
Medical Physician Assistant
1508649310
OK
363AS0400X
Surgical Physician Assistant
Primary
1508649310
OK
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/15/2023
Last updated
06/01/2026
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