Provider Demographics
NPI:1700301900
Name:CAPEHART, ERICA MICHELLE (LAT, ATC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:MICHELLE
Last Name:CAPEHART
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 CUTLASS DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2024
Mailing Address - Country:US
Mailing Address - Phone:702-461-7463
Mailing Address - Fax:
Practice Address - Street 1:700 COLLEGE DR # B138
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-8419
Practice Address - Country:US
Practice Address - Phone:702-651-3553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV05064972255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer