Provider Demographics
NPI:1598087090
Name:SIMCOE, ERICA MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:MARIE
Last Name:SIMCOE
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 1:1862 TOWNE PARK DR
Mailing Address - Street 2:6B
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-8336
Mailing Address - Country:US
Mailing Address - Phone:937-475-2822
Mailing Address - Fax:
Practice Address - Street 1:1862 TOWNE PARK DR
Practice Address - Street 2:6B
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-8336
Practice Address - Country:US
Practice Address - Phone:937-475-2822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.137769-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse