Provider Demographics
NPI:1275784589
Name:HENN, ERIN ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ELIZABETH
Last Name:HENN
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1212 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-5600
Mailing Address - Country:US
Mailing Address - Phone:269-344-0874
Mailing Address - Fax:269-344-7256
Practice Address - Street 1:1212 S PARK ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-5600
Practice Address - Country:US
Practice Address - Phone:269-344-0874
Practice Address - Fax:269-344-7256
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2023-04-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601005397207X00000X, 208600000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery