Healthcare Provider Details

I. General information

NPI: 1669839932
Provider Name (Legal Business Name): ERIN LIND DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2016
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4225 WOODBINE RD STE C
PACE FL
32571-8791
US

IV. Provider business mailing address

4744 WILLBEN ST
NORFOLK VA
23518-1921
US

V. Phone/Fax

Practice location:
  • Phone: 850-983-4493
  • Fax:
Mailing address:
  • Phone: 502-544-3236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024173121
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: