Provider Demographics
NPI:1629329867
Name:DUFF, ERIN (NP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:DUFF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 KELLE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-8708
Mailing Address - Country:US
Mailing Address - Phone:219-364-4004
Mailing Address - Fax:219-326-2584
Practice Address - Street 1:104 E CULVER RD STE 102
Practice Address - Street 2:
Practice Address - City:KNOX
Practice Address - State:IN
Practice Address - Zip Code:46534-2241
Practice Address - Country:US
Practice Address - Phone:574-772-7918
Practice Address - Fax:574-772-0894
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28172170A363L00000X
IN71004187A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000837367OtherBCBS
IN201116160Medicaid
IN187730016Medicare PIN