Provider Demographics
NPI:1093295396
Name:PILGRIM, ERIN NICOLE (NP-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:PILGRIM
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 TECHNOLOGY PKWY NW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1369
Mailing Address - Country:US
Mailing Address - Phone:762-235-1000
Mailing Address - Fax:
Practice Address - Street 1:85 JOHN MADDOX DRIVE CONNECTOR NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1233
Practice Address - Country:US
Practice Address - Phone:762-235-3730
Practice Address - Fax:706-234-9732
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN231876363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner