Provider Demographics
NPI:1720358690
Name:ROLFES, ERICA RENAY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:RENAY
Last Name:ROLFES
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 1:547 PRYTANIA AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-2910
Mailing Address - Country:US
Mailing Address - Phone:513-293-5872
Mailing Address - Fax:
Practice Address - Street 1:547 PRYTANIA AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-2910
Practice Address - Country:US
Practice Address - Phone:513-293-5872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.121946IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse