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General NPI Number Information
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NPI Number | 1649653320
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Entity Type | Individual
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Provider Name | ERIN PEARCY P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 06/30/2015
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Provider Practice Location Address
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Address Line | 203 HOSPITAL DR
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City | RATON
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State | NM
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Zip | 87740-2012
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Country | US
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Telephone | 575-445-3661
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Fax |
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Provider Business Mailing Address
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Address Line | 2977 NICKEL ST
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City | LOS ALAMOS
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State | NM
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Zip | 87544-2198
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Country | US
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Telephone | 505-999-0819
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA2015-0040
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License Number State | NM
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