Erica Marie Wall Nurse Practitioner in Psychiatry PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ERICA MARIE WALL NURSE PRACTITIONER IN PSYCHIATRY PLLC

Practice address

321 Broadway
Rensselaer, NY 12144-2602

Phone

(518) 453-2280

Fax

(518) 453-2282

NPI assigned

Apr 24, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Erica Marie Wall, PMHNP-BC

Title

Owner

Phone

(518) 364-5854

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1548016256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 BROADWAY",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121442602",
            "telephone_number": "518-453-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 BROADWAY",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121442602",
            "telephone_number": "518-453-2280",
            "fax_number": "518-453-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICA MARIE WALL NURSE PRACTITIONER IN PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-364-5854",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1083152136",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07741220",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi Edwards
• Allissa Eiser, RDN, CDN
• Lori Ellis
• Sharon Emerson, LCSW
• Ernest M Enzien Jr., MD
• Carol Evans
• Valerie Fairhurst
• Danielle Farnsworth
• Judith Farrell
• Jerrinna Faulkner

• Psychiatric/Mental Health Nurse Practitioner in Rensselaer, NY
• Providers in Rensselaer, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.