| NPI | 1639866866 |
|---|---|
| Former Name | ERICA GRACE COPPEDGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA 724181) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MO 2016029412) |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-19 |