Healthcare Provider Details

I. General information

NPI: 1104110584
Provider Name (Legal Business Name): ERIN ASHLEY KANN MCCARTHY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN ASHLEY KANN NP

II. Dates (important events)

Enumeration Date: 06/03/2011
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 HEALTHY WAY SUITE 330
VIRGINIA BEACH VA
23462-7958
US

IV. Provider business mailing address

828 HEALTHY WAY SUITE 330
VIRGINIA BEACH VA
23462-7958
US

V. Phone/Fax

Practice location:
  • Phone: 757-461-3890
  • Fax: 757-467-0301
Mailing address:
  • Phone: 757-461-3890
  • Fax: 757-467-0301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0024169377
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: