Provider Demographics
NPI:1578050753
Name:MC NEARNEY, ERICA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:MC NEARNEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 SHERMAN ST STE 470
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2988
Mailing Address - Country:US
Mailing Address - Phone:651-209-6520
Mailing Address - Fax:
Practice Address - Street 1:360 SHERMAN ST STE 470
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2988
Practice Address - Country:US
Practice Address - Phone:651-209-6520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN105574225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist