Provider Demographics
NPI:1619353729
Name:LYTHCOTT, ERICA (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:LYTHCOTT
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:NOELLE
Other - Last Name:LYTHCOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:47 N CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08609-1011
Mailing Address - Country:US
Mailing Address - Phone:609-396-8787
Mailing Address - Fax:609-396-6280
Practice Address - Street 1:47 N CLINTON AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08609-1011
Practice Address - Country:US
Practice Address - Phone:609-396-8787
Practice Address - Fax:609-396-6280
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR12251300163WC0400X
PARN625297163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult