Provider Demographics
NPI:1376073080
Name:POURNARAS, ERIN MARINA (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARINA
Last Name:POURNARAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 OKATIE VILLAGE DR STE 103-110
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7527
Mailing Address - Country:US
Mailing Address - Phone:843-368-5962
Mailing Address - Fax:
Practice Address - Street 1:198 OKATIE VILLAGE DR STE 103-110
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909-7527
Practice Address - Country:US
Practice Address - Phone:843-368-5962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant