Provider Demographics
NPI:1538658125
Name:RATHJEN, ERIN REBECCA (ARNP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:REBECCA
Last Name:RATHJEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 1/2 KANUGA DR APT 4
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-7747
Mailing Address - Country:US
Mailing Address - Phone:561-707-6528
Mailing Address - Fax:
Practice Address - Street 1:3365 BURNS RD STE 101
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4302
Practice Address - Country:US
Practice Address - Phone:561-775-1061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9361352363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner