Basic Information
| Provider Information | |||||||||
| NPI: | 1912239476 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBERTS | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 N DELAWARE ST | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | SANDUSKY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484711009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8106483770 | ||||||||
| FaxNumber: | 8106483352 | ||||||||
| Practice Location | |||||||||
| Address1: | 114 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064132112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606640787 | ||||||||
| FaxNumber: | 8606641982 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2010 | ||||||||
| LastUpdateDate: | 08/31/2015 | ||||||||
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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 | 363LF0000X | 4704243791 | MI | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 6106 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.