Provider Demographics
NPI:1467169177
Name:TANKOOS, ERIN (FNP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:TANKOOS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 ALCOVE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8574
Mailing Address - Country:US
Mailing Address - Phone:704-660-4750
Mailing Address - Fax:704-660-4751
Practice Address - Street 1:517 ALCOVE RD STE 102
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8574
Practice Address - Country:US
Practice Address - Phone:704-660-4750
Practice Address - Fax:704-660-4751
Is Sole Proprietor?:No
Enumeration Date:2022-11-02
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017183363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner