Provider Demographics
NPI:1609050715
Name:PINKIE, ERIC ANTHONY (CRNA)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:ANTHONY
Last Name:PINKIE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 652
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-0652
Mailing Address - Country:US
Mailing Address - Phone:765-521-1516
Mailing Address - Fax:765-599-3131
Practice Address - Street 1:1000 N 16TH ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362-4319
Practice Address - Country:US
Practice Address - Phone:765-521-0890
Practice Address - Fax:765-521-1331
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28126748A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered