Individual
MRS. ERICA DANIELLE KETCHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3903 E US HIGHWAY 30, MERRILLVILLE, IN 46410-5810
(219) 736-0900
Mailing address
4420 E 61ST AVE, HOBART, IN 46342-6517
(219) 617-9089
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28167043A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006700A
IN
Other
Enumeration date
10/28/2016
Last updated
11/22/2021
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