Healthcare Provider Details

I. General information

NPI: 1679369763
Provider Name (Legal Business Name): ERIN MARIE MCMAHON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 INDEPENDENCE RD
CANON CITY CO
81212-9380
US

IV. Provider business mailing address

403 N ORCHARD AVE
CANON CITY CO
81212-2540
US

V. Phone/Fax

Practice location:
  • Phone: 719-275-2351
  • Fax: 719-269-9386
Mailing address:
  • Phone: 719-409-7014
  • Fax: 719-966-8672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1000982-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: