Healthcare Provider Details

I. General information

NPI: 1285108365
Provider Name (Legal Business Name): ERIN MICHELLE GREENSPAN ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2019
Last Update Date: 01/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 GALISTEO ST
SANTA FE NM
87505-8876
US

IV. Provider business mailing address

646 GALISTEO ST
SANTA FE NM
87505-8876
US

V. Phone/Fax

Practice location:
  • Phone: 347-451-8273
  • Fax:
Mailing address:
  • Phone: 347-451-8273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number60913185
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: