Provider Demographics
NPI:1275147423
Name:BARNUM, ERIN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:BARNUM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:MARIE
Other - Last Name:DROUILLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:302 HOBART ST
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-2379
Mailing Address - Country:US
Mailing Address - Phone:231-876-2644
Mailing Address - Fax:231-876-5106
Practice Address - Street 1:302 HOBART ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-2379
Practice Address - Country:US
Practice Address - Phone:231-876-2644
Practice Address - Fax:231-876-5106
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI5601011001363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program