Basic Information
| Provider Information | |||||||||
| NPI: | 1538259825 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHEA | ||||||||
| FirstName: | ERIKA | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 MARKET STREET | ||||||||
| Address2: | LM 500 WEST TOWER | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191202100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159852595 | ||||||||
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| Practice Location | |||||||||
| Address1: | 412 W LEHIGH AVE | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191333148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157652272 | ||||||||
| FaxNumber: | 2154265123 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2006 | ||||||||
| LastUpdateDate: | 07/19/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | SP008206 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 30066990 | 01 | PA | KEYSTONE MERCY | OTHER | 42448 | 01 | UNIVERSITY HEALTHPLAN | OTHER | 1452893 | 01 | CIGNA | OTHER | 1538259825 | 01 | PA | HEALTH PARTNERS | OTHER | 2565975 | 01 | UNITED HEALTHCARE | OTHER | 60020564 | 01 | HORIZON NJ HEALTH | OTHER | 010006972 | 01 | AMERICHOICE | OTHER | 1025162600001 | 05 | PA | MEDICAID | 3K6507 | 01 | HEALTHNET | OTHER | P3546319 | 01 | OXFORD | OTHER |