Healthcare Provider Details

I. General information

NPI: 1962293514
Provider Name (Legal Business Name): ERIN R EPPICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36000 EUCLID AVE
WILLOUGHBY OH
44094-4625
US

IV. Provider business mailing address

11620 TALL PINES DR
CHARDON OH
44024-8729
US

V. Phone/Fax

Practice location:
  • Phone: 440-321-2025
  • Fax:
Mailing address:
  • Phone: 440-321-2025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: