Provider Demographics
NPI:1235407529
Name:TOLBERT-SCARBOROUGH, ERICA NICOLE (LPN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:NICOLE
Last Name:TOLBERT-SCARBOROUGH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 WYNDTREE DR
Mailing Address - Street 2:245
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-8757
Mailing Address - Country:US
Mailing Address - Phone:513-508-3363
Mailing Address - Fax:
Practice Address - Street 1:4502 WYNDTREE DR
Practice Address - Street 2:245
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-8757
Practice Address - Country:US
Practice Address - Phone:513-907-2473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN133842 IV MED164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse