Provider Demographics
NPI:1104467406
Name:MORRELL, ERIN M (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:MORRELL
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 CANDLEWOOD CT UNIT 212
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-6616
Mailing Address - Country:US
Mailing Address - Phone:203-856-8090
Mailing Address - Fax:
Practice Address - Street 1:433 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4067
Practice Address - Country:US
Practice Address - Phone:212-998-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001286266163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice