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General NPI Number Information
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NPI Number | 1700301900
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Entity Type | Individual
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Provider Name | ERICA MICHELLE CAPEHART LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 08/08/2017
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 700 COLLEGE DR # B138
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City | HENDERSON
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State | NV
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Zip | 89002-8419
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Country | US
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Telephone | 702-651-3553
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Fax |
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Provider Business Mailing Address
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Address Line | 1915 CUTLASS DR
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City | HENDERSON
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State | NV
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Zip | 89014-2024
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Country | US
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Telephone | 702-461-7463
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0506497
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License Number State | NV
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