Provider Demographics
NPI:1043549082
Name:MARCOTTE, ERICA RACHEL (LPN)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:RACHEL
Last Name:MARCOTTE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:RACHEL
Other - Last Name:BOURQUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:PO BOX 295
Mailing Address - Street 2:
Mailing Address - City:CHARENTON
Mailing Address - State:LA
Mailing Address - Zip Code:70523-0295
Mailing Address - Country:US
Mailing Address - Phone:337-578-0691
Mailing Address - Fax:
Practice Address - Street 1:1907 CHINABERRY ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:LA
Practice Address - Zip Code:70538-5236
Practice Address - Country:US
Practice Address - Phone:337-828-1918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA280614164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse