MEDICARE: ELLEN E ERWIN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	1296114	MN

General Provider Information

NPI Number	:	1932886314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN E ERWIN RN

Provider Business Mailing Address
First Line	:	5304 XERXES AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55410-2449
Country	:	US
Telephone Number	:	612-834-2292
Fax Number	:

Provider Business Practice Location Address
First Line	:	5304 XERXES AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55410-2449
Country	:	US
Telephone Number	:	612-834-2292
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2023
Last Update Date	:	06/28/2023

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Directions to “ ELLEN E ERWIN RN” Practice Location

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