Basic Information
| Provider Information | |||||||||
| NPI: | 1194788661 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VONREIN | ||||||||
| FirstName: | ERINN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5911 OXFORD ST | ||||||||
| Address2: | APT 1 | ||||||||
| City: | ST LOUIS PARK | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554165126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529469777 | ||||||||
| FaxNumber: | 9529469888 | ||||||||
| Practice Location | |||||||||
| Address1: | 8100 W 78TH ST | ||||||||
| Address2: | SUITE 225 | ||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554392516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529469777 | ||||||||
| FaxNumber: | 9529469888 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 10071 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 1045679 | 01 | MN | PREFERRED ONE | OTHER | 0122208 | 01 | MN | SELECT CARE | OTHER | 122208 | 01 | MN | PATIENT CHOICE | OTHER | 2406637 | 01 | MN | AMERICAS PPO | OTHER | 0122208 | 01 | MN | MEDICA | OTHER | 262P6VO | 01 | MN | BLUE CROSS | OTHER | HP58062 | 01 | MN | HEALTHPARTNERS | OTHER | 181974 | 01 | MN | UCARE | OTHER |