Provider Demographics
NPI:1427392265
Name:LYKE, ERIN FAITH
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:FAITH
Last Name:LYKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67085 COUNTY ROAD 9
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55041-5652
Mailing Address - Country:US
Mailing Address - Phone:612-247-9683
Mailing Address - Fax:
Practice Address - Street 1:1450 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-2113
Practice Address - Country:US
Practice Address - Phone:507-280-0193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-17
Last Update Date:2012-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR206864-2163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health