Basic Information
Provider Information
NPI: 1801358635
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AZURIN
FirstName: ERIKA
MiddleName: MAE
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: VILLAPAZ
OtherFirstName: ERIKA MAE
OtherMiddleName: OBANDO
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 101 SIVLEY RD SW
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358014470
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 101 SIVLEY RD SW
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358014470
CountryCode: US
TelephoneNumber: 2562651000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/01/2019
LastUpdateDate: 04/01/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X1-158987ALY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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