Healthcare Provider Details

I. General information

NPI: 1720278096
Provider Name (Legal Business Name): ERIN KATHLEEN ATHEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 10/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 SOUTHERN AVE SE
WASHINGTON DC
20032-4623
US

IV. Provider business mailing address

1310 SOUTHERN AVE SE
WASHINGTON DC
20032-4623
US

V. Phone/Fax

Practice location:
  • Phone: 202-574-5432
  • Fax: 202-574-7188
Mailing address:
  • Phone: 202-574-5432
  • Fax: 202-574-7188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1009870
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: