Provider Demographics
NPI:1114215381
Name:FOSTER-VRENON, ERIN (APRN)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:FOSTER-VRENON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 WATERLOO LN
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89410-5385
Mailing Address - Country:US
Mailing Address - Phone:775-782-9038
Mailing Address - Fax:775-782-9043
Practice Address - Street 1:1329 WATERLOO LN
Practice Address - Street 2:
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410-5385
Practice Address - Country:US
Practice Address - Phone:775-782-9038
Practice Address - Fax:775-782-9043
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001289363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV12400702OtherCAQH