Provider Demographics
NPI:1780853523
Name:ERB, MARILYN JOANNE (HHA)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:JOANNE
Last Name:ERB
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 HARVEST DR
Mailing Address - Street 2:APT. E
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-7729
Mailing Address - Country:US
Mailing Address - Phone:765-319-3572
Mailing Address - Fax:
Practice Address - Street 1:854 HARVEST DR
Practice Address - Street 2:APT. E
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-7729
Practice Address - Country:US
Practice Address - Phone:765-319-3572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33030701778374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide