Provider Demographics
NPI:1568554434
Name:LEW, ERIN C (CNP, RN)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:C
Last Name:LEW
Suffix:
Gender:F
Credentials:CNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 WEST BROADWAY
Mailing Address - Street 2:SUITE 1065
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422
Mailing Address - Country:US
Mailing Address - Phone:763-520-1137
Mailing Address - Fax:763-520-1976
Practice Address - Street 1:500 OSBORNE ROAD
Practice Address - Street 2:SUITE 215
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432
Practice Address - Country:US
Practice Address - Phone:763-786-1620
Practice Address - Fax:763-780-2624
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1403761364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN87G85LEOtherBLUE CROSS BLUE SHIELD
MN182800OtherUCARE
MN963001046587OtherPREFERRED ONE
MN0122479OtherMEDICA
MN0122479OtherSELECT CARE
MNP59130OtherHEALTH PARTNERS
MN87G85LEOtherBLUE CROSS BLUE SHIELD