Provider Demographics
NPI:1609360098
Name:DUNPHY, ERIN M (OD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:M
Last Name:DUNPHY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13900 NORTHDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-9627
Mailing Address - Country:US
Mailing Address - Phone:847-209-3231
Mailing Address - Fax:763-428-9820
Practice Address - Street 1:13900 NORTHDALE BLVD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374
Practice Address - Country:US
Practice Address - Phone:763-428-3757
Practice Address - Fax:763-428-9820
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-19
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3569152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist