Individual
ERIKA B LAUDERDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1010 PRINCE AVE STE 300, ATHENS, GA 30606-5805
(706) 425-1470
Mailing address
7714 POPLAR AVE STE 200, GERMANTOWN, TN 38138-3941
(901) 683-0055
(901) 685-2969
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11321
GA
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
935973
MEDICARE MS
MS
05
—
PENDING
—
MS
05
—
Q034221
—
TN
01
—
T11874A
MEDICARE TN
TN
Enumeration date
09/29/2017
Last updated
02/27/2023
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