Provider Demographics
NPI:1679024905
Name:CROOK, ERIN HELTON (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:HELTON
Last Name:CROOK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:HELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2253 CHAMBLISS AVE NW STE 301
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-3961
Mailing Address - Country:US
Mailing Address - Phone:423-476-4466
Mailing Address - Fax:423-476-4487
Practice Address - Street 1:2253 CHAMBLISS AVE NW STE 301
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3961
Practice Address - Country:US
Practice Address - Phone:423-476-4466
Practice Address - Fax:423-476-4487
Is Sole Proprietor?:No
Enumeration Date:2016-10-21
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA3123363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ036771Medicaid