Provider Demographics
NPI:1922616812
Name:ERDMANN, MICHELE LYNN (RN)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:LYNN
Last Name:ERDMANN
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 1:115 ROUTE 46 W STE 32
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07046-1668
Mailing Address - Country:US
Mailing Address - Phone:973-919-9781
Mailing Address - Fax:
Practice Address - Street 1:115 ROUTE 46 W STE 32
Practice Address - Street 2:
Practice Address - City:MOUNTAIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07046-1668
Practice Address - Country:US
Practice Address - Phone:973-919-9781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR10390100163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse