MEDICARE: ERIKA VOTAW LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	PN-156778	OH

General Provider Information

NPI Number	:	1316301161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA VOTAW LPN

Provider Business Mailing Address
First Line	:	2974 COUNTY ROAD 170
Second Line	:	APT. A
City	:	MARENGO
State	:	OH
Zip	:	43334-9201
Country	:	US
Telephone Number	:	740-396-9671
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 MEADOW DR
Second Line	:	SUITE A
City	:	MOUNT GILEAD
State	:	OH
Zip	:	43338-1389
Country	:	US
Telephone Number	:	419-947-4560
Fax Number	:	419-947-2956

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2016
Last Update Date	:	04/07/2016

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