Provider Demographics
NPI:1942078076
Name:MACKEL, ERIN (BSN, RN, NBC-HWC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MACKEL
Suffix:
Gender:F
Credentials:BSN, RN, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 WELCH AVE
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-2935
Mailing Address - Country:US
Mailing Address - Phone:802-363-6505
Mailing Address - Fax:
Practice Address - Street 1:44 WELCH AVE
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-2935
Practice Address - Country:US
Practice Address - Phone:802-363-6505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10.134696163W00000X
MARN2351012163W00000X
CTA-3783898171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No163W00000XNursing Service ProvidersRegistered Nurse