Provider Demographics
NPI:1528383189
Name:CORDE, ERIN N (LPN)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:N
Last Name:CORDE
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 1:5677 BALDOYLE WAY
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-7946
Mailing Address - Country:US
Mailing Address - Phone:614-622-3633
Mailing Address - Fax:614-834-2730
Practice Address - Street 1:5677 BALDOYLE WAY
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-7946
Practice Address - Country:US
Practice Address - Phone:614-622-3633
Practice Address - Fax:614-834-2730
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH139270164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse