Provider Demographics
NPI:1801165113
Name:VAN DER VEER, ERIN C (NP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:C
Last Name:VAN DER VEER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CHAUNCY ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-1202
Mailing Address - Country:US
Mailing Address - Phone:508-339-7434
Mailing Address - Fax:508-339-5837
Practice Address - Street 1:205 CHAUNCY ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-1202
Practice Address - Country:US
Practice Address - Phone:508-339-7434
Practice Address - Fax:508-339-5837
Is Sole Proprietor?:No
Enumeration Date:2011-12-16
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2258701363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily