Healthcare Provider Details

I. General information

NPI: 1184077265
Provider Name (Legal Business Name): ERIN MARIE MCKAY CNP, BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2016
Last Update Date: 07/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 COOPER FOSTER PARK RD W
LORAIN OH
44053-4152
US

IV. Provider business mailing address

5700 COOPER FOSTER PARK RD W
LORAIN OH
44053-4152
US

V. Phone/Fax

Practice location:
  • Phone: 440-204-7400
  • Fax: 440-204-7203
Mailing address:
  • Phone: 440-204-7400
  • Fax: 440-204-7203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN.347534
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberRN.347534
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: