Provider Demographics
NPI:1578815486
Name:GOLD, ERIN HANNAH (RN, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:HANNAH
Last Name:GOLD
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-4659
Mailing Address - Country:US
Mailing Address - Phone:978-783-5030
Mailing Address - Fax:
Practice Address - Street 1:323 LOWELL ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-4659
Practice Address - Country:US
Practice Address - Phone:978-783-5030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH080336-21163W00000X
MARN2282081163WP0200X, 363LP0200X
NY22 643553163WP0200X
NH080336-23363LP0200X
NY382351363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03618706Medicaid