1639465941 NPI number — ERIKA ANNE DONALIS RPA-C

Table of content: ERIKA ANNE DONALIS RPA-C (NPI 1639465941)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639465941 NPI number — ERIKA ANNE DONALIS RPA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DONALIS
Provider First Name:
ERIKA
Provider Middle Name:
ANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RPA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639465941
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 936857
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31193-6857
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-662-6200
Provider Business Mailing Address Fax Number:
910-686-1606

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7420 MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28411-9453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-662-6200
Provider Business Practice Location Address Fax Number:
910-550-3787
Provider Enumeration Date:
06/24/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  014812 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: 0010-12459 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 03588034 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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