Provider Demographics
NPI:1255773073
Name:SCANLON, ERICA LAUREN
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LAUREN
Last Name:SCANLON
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 1:34 SAGEBRUSH LN
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018-2641
Mailing Address - Country:US
Mailing Address - Phone:859-240-4446
Mailing Address - Fax:
Practice Address - Street 1:34 SAGEBRUSH LN
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-2641
Practice Address - Country:US
Practice Address - Phone:859-240-4446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator