Provider Demographics
NPI:1760890354
Name:HEALEY, ERIN MARY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARY
Last Name:HEALEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3735 HWAY 95
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-8199
Mailing Address - Country:US
Mailing Address - Phone:928-444-1444
Mailing Address - Fax:928-444-1445
Practice Address - Street 1:3735 HWAY 95
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-8199
Practice Address - Country:US
Practice Address - Phone:928-444-1444
Practice Address - Fax:928-444-1445
Is Sole Proprietor?:No
Enumeration Date:2014-07-27
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5704363LF0000X
NVTAPRN701047363LF0000X
NVAPRN001819363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily