Provider Demographics
NPI:1720016082
Name:MARVIN, ERIN D (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:D
Last Name:MARVIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:D
Other - Last Name:BOLLIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7887 E BELLEVIEW AVE
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6015
Mailing Address - Country:US
Mailing Address - Phone:303-703-9151
Mailing Address - Fax:303-835-0025
Practice Address - Street 1:7887 E BELLEVIEW AVE
Practice Address - Street 2:SUITE 1100
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-6015
Practice Address - Country:US
Practice Address - Phone:303-703-9151
Practice Address - Fax:303-835-0025
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2222363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant