Provider Demographics
NPI:1598837619
Name:KEARNEY, ERIN (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:KEARNEY
Other - Last Name:CONRAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:3014 SEALY ST
Mailing Address - Street 2:#158
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-4218
Mailing Address - Country:US
Mailing Address - Phone:409-761-6216
Mailing Address - Fax:409-770-0298
Practice Address - Street 1:3014 SEALY ST
Practice Address - Street 2:#158
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-4218
Practice Address - Country:US
Practice Address - Phone:409-761-6216
Practice Address - Fax:409-770-0298
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05088363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA05088OtherPHYSICIAN ASSISTANT