| Doctor Name: | ERICA LEE ERTEL |
| NPI Number: | 1013381037 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | COA. 18374-NP |
| Business Practice Address: | 3737 Southern Blvd Suite 2000 Kettering, OH - 454291262 |
| Business Phone Number: | 9376101915 |
| Business Fax Number: | 9376101917 |
| Mailing Address: | 3737 Southern Blvd, Suite 2000 KETTERING |
| State: | OH |
| Postal Code: | 454291262 |
| Phone Number: | 9376101915 |
| Fax Number: | 9376101917 |
| NPI Enumeration Date: | 11/16/2015 |
| NPI Last Update Date: | 02/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | COA. 18374-NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |