Provider Demographics
NPI:1831342245
Name:MCELRAVY, ERIN M (APRN/FNP-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:MCELRAVY
Suffix:
Gender:F
Credentials:APRN/FNP-C
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:M
Other - Last Name:COLLIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 950248
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0248
Mailing Address - Country:US
Mailing Address - Phone:812-949-5482
Mailing Address - Fax:812-949-5966
Practice Address - Street 1:1850 STATE ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4990
Practice Address - Country:US
Practice Address - Phone:812-944-7701
Practice Address - Fax:812-981-6505
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003909363LF0000X
KY3005785363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201057530Medicaid
IN201057530Medicaid