Provider Demographics
NPI:1689842650
Name:CORDITA, ERLINDA LLESIS (RN,BSN,CLNC)
Entity Type:Individual
Prefix:MS
First Name:ERLINDA
Middle Name:LLESIS
Last Name:CORDITA
Suffix:
Gender:F
Credentials:RN,BSN,CLNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 VETERANS DRIVE
Mailing Address - Street 2:VETERANS AFFAIRS
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98499
Mailing Address - Country:US
Mailing Address - Phone:253-583-2082
Mailing Address - Fax:253-589-4105
Practice Address - Street 1:9600 VETERANS DRIVE
Practice Address - Street 2:VETERANS AFFAIRS
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98499
Practice Address - Country:US
Practice Address - Phone:253-583-2082
Practice Address - Fax:253-589-4105
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA423679163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse