Provider Demographics
NPI:1093296923
Name:SCHMIDT, ERIN WHITNEY KILGANNON (DNP CPNP - AC/PC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:WHITNEY KILGANNON
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:DNP CPNP - AC/PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 SW GIBBS ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-7326
Mailing Address - Country:US
Mailing Address - Phone:971-237-5386
Mailing Address - Fax:
Practice Address - Street 1:445 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4084
Practice Address - Country:US
Practice Address - Phone:503-640-2757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201807389NP-PP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics