Provider Demographics
NPI:1447842422
Name:ERHART, LAURIE
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:ERHART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15419 WAVERLY RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:NE
Mailing Address - Zip Code:68037-3329
Mailing Address - Country:US
Mailing Address - Phone:402-690-2860
Mailing Address - Fax:
Practice Address - Street 1:15419 WAVERLY RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:NE
Practice Address - Zip Code:68037-3329
Practice Address - Country:US
Practice Address - Phone:402-690-2860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19768164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse