Healthcare Provider Details
I. General information
NPI: 1548776925
Provider Name (Legal Business Name): ERIN TOFANI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/20/2017
Last Update Date: 08/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3834 S EMERSON AVE BUILDING C, SUITE 100
INDIANAPOLIS IN
46203
US
IV. Provider business mailing address
PO BOX 3299
CARSON CITY NV
89702-3299
US
V. Phone/Fax
- Phone: 317-782-1577
- Fax: 888-366-7577
- Phone: 775-222-0044
- Fax: 888-700-0187
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 28149266A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 71007784A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: