Provider Demographics
NPI:1760621544
Name:NEIBAUER, ERIN ELAINE (FNP)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:ELAINE
Last Name:NEIBAUER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ELAINE
Other - Last Name:MULLENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:CROW/NORTHERN CHEYENNE IHS HOSPITAL
Mailing Address - City:CROW AGENCY
Mailing Address - State:MT
Mailing Address - Zip Code:59022-0009
Mailing Address - Country:US
Mailing Address - Phone:406-638-3558
Mailing Address - Fax:406-638-3482
Practice Address - Street 1:1010 SOUTH 7650 EAST CROW
Practice Address - Street 2:NORTHERN CHEYENNE INDIAN HOSP
Practice Address - City:CROW AGENCY
Practice Address - State:MT
Practice Address - Zip Code:59022
Practice Address - Country:US
Practice Address - Phone:406-638-3558
Practice Address - Fax:406-638-3482
Is Sole Proprietor?:No
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTAPN20957363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily