Basic Information
Provider Information
NPI: 1487989836
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARION
FirstName: ERIN
MiddleName: CHRISTINE
NamePrefix: MRS.
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1650 COCHRANE CIR # B7500
Address2:  
City: FT CARSON
State: CO
PostalCode: 809134603
CountryCode: US
TelephoneNumber: 7195267844
FaxNumber: 7195267984
Practice Location
Address1: 1650 COCHRANE CIR # B7500
Address2:  
City: FT CARSON
State: CO
PostalCode: 809134603
CountryCode: US
TelephoneNumber: 7195267844
FaxNumber: 7195267984
Other Information
ProviderEnumerationDate: 10/02/2009
LastUpdateDate: 10/02/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LW0102X180766COY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

No ID Information.


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