Provider Demographics
NPI:1205419520
Name:MECUM, ERIN (PA-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MECUM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 KIRKPATRICK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8066
Mailing Address - Country:US
Mailing Address - Phone:336-538-0565
Mailing Address - Fax:336-538-0564
Practice Address - Street 1:1041 KIRKPATRICK RD STE 100
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215
Practice Address - Country:US
Practice Address - Phone:336-538-0565
Practice Address - Fax:336-538-0564
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NC0010-11243363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant