Provider Demographics
NPI:1558315929
Name:SMITH HERR, ERIN MARIE (CNP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:SMITH HERR
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MARIE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:110 POLARIS PKWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8024
Mailing Address - Country:US
Mailing Address - Phone:614-895-7280
Mailing Address - Fax:614-895-8826
Practice Address - Street 1:110 POLARIS PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8024
Practice Address - Country:US
Practice Address - Phone:614-895-7280
Practice Address - Fax:614-895-8826
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2795033APNP363LF0000X
OHCOA 05807 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P86896Medicare UPIN