Provider Demographics
NPI:1942721790
Name:GAZICH, ERIN M (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:M
Last Name:GAZICH
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:M
Other - Last Name:HENCLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, FNP-C
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-1166
Mailing Address - Fax:
Practice Address - Street 1:310 SMITH AVE N STE 440
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2316
Practice Address - Country:US
Practice Address - Phone:651-241-6550
Practice Address - Fax:651-241-6586
Is Sole Proprietor?:No
Enumeration Date:2017-07-02
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDF06172006363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily