Provider Demographics
NPI:1346711009
Name:BRISTOW, ERIN (NP-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:BRISTOW
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-5923
Mailing Address - Country:US
Mailing Address - Phone:252-438-3549
Mailing Address - Fax:252-438-2875
Practice Address - Street 1:100 W PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5923
Practice Address - Country:US
Practice Address - Phone:252-438-3549
Practice Address - Fax:252-438-2875
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011186363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily