1023450707 NPI number — MRS. ERIN ELIZABETH MCDONOUGH DNP, APRN

Table of content: MRS. ERIN ELIZABETH MCDONOUGH DNP, APRN (NPI 1023450707)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023450707 NPI number — MRS. ERIN ELIZABETH MCDONOUGH DNP, APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCDONOUGH
Provider First Name:
ERIN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DNP, APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LATINA
Provider Other First Name:
ERIN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DNP, APRN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1023450707
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 MCGREGOR ST
Provider Second Line Business Mailing Address:
INTENSIVE CARE UNIT, LEVEL C
Provider Business Mailing Address City Name:
MANCHESTER
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03102-3730
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-663-6401
Provider Business Mailing Address Fax Number:
603-663-2059

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 MCGREGOR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANCHESTER
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03102-3730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-663-6401
Provider Business Practice Location Address Fax Number:
603-663-2059
Provider Enumeration Date:
07/23/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2100X , with the licence number:  RN2276154 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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