Provider Demographics
NPI:1710300637
Name:DUNCAN, ERIN PATRICK (CRNA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:PATRICK
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:REBECCA
Other - Last Name:PATRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 636256
Mailing Address - Street 2:CENTRAL CREDENTIALING
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:US
Mailing Address - Phone:513-585-5502
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:2830 VICTORY PKWY
Practice Address - Street 2:CENTRAL CREDENTIALING - ML 0806
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1785
Practice Address - Country:US
Practice Address - Phone:513-585-5502
Practice Address - Fax:513-585-5511
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.325591-COA1163W00000X
KY3008478367500000X
OHCOA.15531-NA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100282430Medicaid
IN201283690Medicaid
OH0121403Medicaid
IN201283690Medicaid