Provider Demographics
NPI:1699176149
Name:GONZALEZ, ERIN CHRISTINE (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:CHRISTINE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 ANNAPOLIS RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1647
Mailing Address - Country:US
Mailing Address - Phone:410-874-1600
Mailing Address - Fax:
Practice Address - Street 1:1132 ANNAPOLIS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1647
Practice Address - Country:US
Practice Address - Phone:410-874-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2015-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR185479363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics