Individual
ERICA MARIE WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3701 LOOP RD, TUSCALOOSA, AL 35404-5015
(205) 554-2000
Mailing address
1322 RAGLAND GULLY, BRENT, AL 35034-2949
(205) 292-9021
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-062566
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2-062566
STATE
AL
Enumeration date
10/28/2013
Last updated
10/28/2013
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