Healthcare Provider Details

I. General information

NPI: 1609394295
Provider Name (Legal Business Name): ANDREA ERDMANN CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2017
Last Update Date: 09/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 CHICAGO AVE
MINNEAPOLIS MN
55404-4518
US

IV. Provider business mailing address

5901 LINCOLN DR
EDINA MN
55436-1611
US

V. Phone/Fax

Practice location:
  • Phone: 612-813-6000
  • Fax:
Mailing address:
  • Phone: 952-992-5691
  • Fax: 952-992-6917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number5384
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: