Provider Demographics
NPI:1912442591
Name:MCDERMOTT, ERIN (RN)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:853 N CHURCH ST
Mailing Address - Street 2:SUITE 720C
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3098
Mailing Address - Country:US
Mailing Address - Phone:864-560-6419
Mailing Address - Fax:864-560-7498
Practice Address - Street 1:853 N CHURCH ST
Practice Address - Street 2:SUITE 720C
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3098
Practice Address - Country:US
Practice Address - Phone:864-560-6419
Practice Address - Fax:864-560-7498
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29162163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse