Provider Demographics
NPI:1700295334
Name:MYHER, ERICA LYNN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:ERICA
Middle Name:LYNN
Last Name:MYHER
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 1:131 ELMO AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BELOIT
Mailing Address - State:IL
Mailing Address - Zip Code:61080-1218
Mailing Address - Country:US
Mailing Address - Phone:608-346-4928
Mailing Address - Fax:
Practice Address - Street 1:131 ELMO AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BELOIT
Practice Address - State:IL
Practice Address - Zip Code:61080-1218
Practice Address - Country:US
Practice Address - Phone:608-346-4928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI318639164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse