Individual
ERICA L. DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
123 ELMWOOD RD, WALBRIDGE, OH 43465-1428
(419) 514-7480
Mailing address
123 ELMWOOD RD, WALBRIDGE, OH 43465-1428
(419) 514-7480
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
150688
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150688
OHIO BOARD OF NURSING
OH
Enumeration date
11/06/2012
Last updated
11/06/2012
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