Provider Demographics
NPI:1093093361
Name:SINRAM, ERIN (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:SINRAM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANK
Mailing Address - State:IA
Mailing Address - Zip Code:50629-7700
Mailing Address - Country:US
Mailing Address - Phone:319-635-2110
Mailing Address - Fax:319-635-2509
Practice Address - Street 1:105 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:FAIRBANK
Practice Address - State:IA
Practice Address - Zip Code:50629-7700
Practice Address - Country:US
Practice Address - Phone:319-635-2110
Practice Address - Fax:319-635-2509
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002210363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant