Provider Demographics
NPI:1093081671
Name:VAN WHY, ERIN BROOKE (RD)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:BROOKE
Last Name:VAN WHY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 WELLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-6123
Mailing Address - Country:US
Mailing Address - Phone:970-298-7106
Mailing Address - Fax:970-298-7177
Practice Address - Street 1:710 WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-6123
Practice Address - Country:US
Practice Address - Phone:970-298-7106
Practice Address - Fax:970-298-7177
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
896042133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal