Provider Demographics
NPI:1669239315
Name:LACUE, ERIN THERESA (RN)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:THERESA
Last Name:LACUE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:THERESA
Other - Last Name:MCCOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:644 RHOA RD
Mailing Address - Street 2:
Mailing Address - City:PATTON
Mailing Address - State:PA
Mailing Address - Zip Code:16668-8600
Mailing Address - Country:US
Mailing Address - Phone:814-931-7994
Mailing Address - Fax:
Practice Address - Street 1:644 RHOA RD
Practice Address - Street 2:
Practice Address - City:PATTON
Practice Address - State:PA
Practice Address - Zip Code:16668-8600
Practice Address - Country:US
Practice Address - Phone:814-931-7994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN290228L163WS0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty