Healthcare Provider Details

I. General information

NPI: 1558033290
Provider Name (Legal Business Name): ERIN DUKATS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 10/01/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 YOUNGSTOWN WARREN RD
NILES OH
44446-4616
US

IV. Provider business mailing address

116 PITTSBURGH ST
COLUMBIANA OH
44408-1371
US

V. Phone/Fax

Practice location:
  • Phone: 330-505-2601
  • Fax:
Mailing address:
  • Phone: 330-770-7120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0029880
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: