Basic Information
| Provider Information | |||||||||
| NPI: | 1568554434 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | LEW | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | CNP, RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3435 WEST BROADWAY | ||||||||
| Address2: | SUITE 1065 | ||||||||
| City: | ROBBINSDALE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7635201137 | ||||||||
| FaxNumber: | 7635201976 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 OSBORNE ROAD | ||||||||
| Address2: | SUITE 215 | ||||||||
| City: | FRIDLEY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7637861620 | ||||||||
| FaxNumber: | 7637802624 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SX0200X | R1403761 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Oncology |
ID Information
| ID | Type | State | Issuer | Description | 87G85LE | 01 | MN | BLUE CROSS BLUE SHIELD | OTHER | 182800 | 01 | MN | UCARE | OTHER | 963001046587 | 01 | MN | PREFERRED ONE | OTHER | 0122479 | 01 | MN | MEDICA | OTHER | 0122479 | 01 | MN | SELECT CARE | OTHER | P59130 | 01 | MN | HEALTH PARTNERS | OTHER |