Provider Demographics
NPI:1235661661
Name:BOLAND, ERIN CATHERINE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:CATHERINE
Last Name:BOLAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5565 BLAINE AVE
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-1238
Mailing Address - Country:US
Mailing Address - Phone:651-241-9400
Mailing Address - Fax:651-241-9366
Practice Address - Street 1:5565 BLAINE AVE
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-1238
Practice Address - Country:US
Practice Address - Phone:651-241-9400
Practice Address - Fax:651-241-9366
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5093363L00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner