Provider Demographics
NPI:1700475191
Name:ERCOLANI, VERONICA (RN)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:ERCOLANI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5567 AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-4119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5567 AUBURN RD
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48317-4119
Practice Address - Country:US
Practice Address - Phone:586-946-0423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2023-11-20
Deactivation Date:2021-11-18
Deactivation Code:
Reactivation Date:2023-11-20
Provider Licenses
StateLicense IDTaxonomies
MI4704359454163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse