Provider Demographics
NPI:1497028237
Name:DELMORE, ERICA L (DEM)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:L
Last Name:DELMORE
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 MARYLAND HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-7931
Mailing Address - Country:US
Mailing Address - Phone:702-324-3206
Mailing Address - Fax:
Practice Address - Street 1:610 S 8TH ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-7005
Practice Address - Country:US
Practice Address - Phone:702-483-3248
Practice Address - Fax:702-825-0795
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8786174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV374J00000XOtherDOULA SERVICES