Provider Demographics
NPI:1639795495
Name:EARHART, ERIN KATHERINE (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:KATHERINE
Last Name:EARHART
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 W UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7822
Mailing Address - Country:US
Mailing Address - Phone:469-441-4595
Mailing Address - Fax:
Practice Address - Street 1:221 W COLORADO BLVD STE 525
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2312
Practice Address - Country:US
Practice Address - Phone:214-960-5681
Practice Address - Fax:214-960-5681
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2023-08-31
Deactivation Date:2020-07-10
Deactivation Code:
Reactivation Date:2020-09-18
Provider Licenses
StateLicense IDTaxonomies
TX776126163WC0200X
TX1002807363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine