Provider Demographics
NPI:1609018258
Name:CATES, ERICA MAE (LPN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:MAE
Last Name:CATES
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 1:573 BAILEY DR
Mailing Address - Street 2:APARTMENT 11
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44904-2001
Mailing Address - Country:US
Mailing Address - Phone:419-989-7094
Mailing Address - Fax:
Practice Address - Street 1:573 BAILEY DR
Practice Address - Street 2:APARTMENT 11
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44904-2001
Practice Address - Country:US
Practice Address - Phone:419-989-7094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-28
Last Update Date:2009-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 127918 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse