Provider Demographics
NPI:1013620178
Name:GUTHAUS, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:GUTHAUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 ELLEN AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-3412
Mailing Address - Country:US
Mailing Address - Phone:616-834-7174
Mailing Address - Fax:
Practice Address - Street 1:3115 ELLEN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-3412
Practice Address - Country:US
Practice Address - Phone:616-834-7174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty