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NPI 1871232371

NPI 1871232371 : ERIN COCHRANE HUNTOON : VADNAIS HEIGHTS, MN

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General NPI Number Information
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    NPI Number           |    1871232371
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    Entity Type          |    Individual 
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    Provider Name        |    ERIN COCHRANE HUNTOON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/02/2022
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    Last Update Date     |    10/10/2024
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Provider Practice Location Address
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    Address Line         |    1155 COUNTY ROAD E E STE 100 
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    City                 |    VADNAIS HEIGHTS
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    State                |    MN
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    Zip                  |    55110-5191
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    Country              |    US
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    Telephone            |    651-241-9200
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    Fax                  |    651-241-9603
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Provider Business Mailing Address
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    Address Line         |    PO BOX 43 
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    City                 |    MINNEAPOLIS
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    State                |    MN
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    Zip                  |    55440-0043
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    Country              |    US
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    Telephone            |    612-262-1166
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    14940
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    License Number State |    MN
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