Provider Demographics
NPI:1497413215
Name:ERWIN, MICHAELA LYNN (DC)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:LYNN
Last Name:ERWIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 43RD AVE NE APT 206
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-8089
Mailing Address - Country:US
Mailing Address - Phone:218-298-1961
Mailing Address - Fax:
Practice Address - Street 1:215 W MAIN AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3741
Practice Address - Country:US
Practice Address - Phone:701-255-4241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor