Proctor, Erin L

Proctor, Erin L is an individual health care provider with primary practice located at 315 E. Elm Ste. 100 , Caldwell ID 83605-4858. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Proctor, Erin L can be contacted via phone (208) 459-7415.

Contact Information

Primary practice address
315 E. Elm Ste. 100 Caldwell ID 83605-4858
Phone: (208) 459-7415
Fax: (208) 453-3307
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA 515 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-515 Idaho

Profile Details

NPI number 1811987076
LBN Legal business name Proctor, Erin L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2005
Last updated Jan 10th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811987076 NPPES
Idaho MEDICAID 807034000

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