Healthcare Provider Details

I. General information

NPI: 1104467406
Provider Name (Legal Business Name): ERIN M MORRELL AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2019
Last Update Date: 10/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 1ST AVE
NEW YORK NY
10010-4067
US

IV. Provider business mailing address

1830 CANDLEWOOD CT UNIT 212
CHARLOTTESVILLE VA
22903-6616
US

V. Phone/Fax

Practice location:
  • Phone: 212-998-4500
  • Fax:
Mailing address:
  • Phone: 203-856-8090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number0001286266
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: