Provider Demographics
NPI:1043737521
Name:KENNEDY-RIPLEY, ERIN REGAN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:REGAN
Last Name:KENNEDY-RIPLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 MOUNT PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:PA
Mailing Address - Zip Code:18013-9282
Mailing Address - Country:US
Mailing Address - Phone:484-903-3338
Mailing Address - Fax:
Practice Address - Street 1:2720 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4810
Practice Address - Country:US
Practice Address - Phone:803-936-7372
Practice Address - Fax:803-936-4102
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017842363LA2100X
SC26851363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care