MEDICARE: MS. EILEEN RUDEGEAIR ERSKINE CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	R097607	MD

General Provider Information

NPI Number	:	1306976006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EILEEN RUDEGEAIR ERSKINE CRNP

Provider Business Mailing Address
First Line	:	12510 PROSPERITY DR
Second Line	:	SUITE 200
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-1663
Country	:	US
Telephone Number	:	240-485-5210
Fax Number	:

Provider Business Practice Location Address
First Line	:	5550 KNOLL NORTH DRIVE
Second Line	:	SUITE 460
City	:	COLUMBIA
State	:	MD
Zip	:	21045-0000
Country	:	US
Telephone Number	:	410-730-9363
Fax Number	:	410-730-2084

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	08/20/2015

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