Provider Demographics
NPI:1790004430
Name:JOHNSON, ERIN ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 ROOT RD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-9832
Mailing Address - Country:US
Mailing Address - Phone:413-568-3942
Mailing Address - Fax:413-568-5983
Practice Address - Street 1:209 ROOT RD
Practice Address - Street 2:SUITE #2
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-9832
Practice Address - Country:US
Practice Address - Phone:413-568-3942
Practice Address - Fax:413-568-5983
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2265413163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse