Provider Demographics
NPI:1487197281
Name:MANSOUR, ERIN MICHELLE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MICHELLE
Last Name:MANSOUR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MICHELLE
Other - Last Name:COTHRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5151 N 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8721
Mailing Address - Country:US
Mailing Address - Phone:713-449-1790
Mailing Address - Fax:
Practice Address - Street 1:5151 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8721
Practice Address - Country:US
Practice Address - Phone:713-449-1790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9421360363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics