Provider Demographics
NPI:1235816950
Name:TATA, ERICA PRECIOUS (LPN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:PRECIOUS
Last Name:TATA
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 1:5433 ACAPULCO PL
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-4301
Mailing Address - Country:US
Mailing Address - Phone:614-316-7201
Mailing Address - Fax:
Practice Address - Street 1:5433 ACAPULCO PL
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-4301
Practice Address - Country:US
Practice Address - Phone:614-316-7201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-04
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty