Provider Demographics
NPI:1144510926
Name:ABERNETHY, ERIN A (PA)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:A
Last Name:ABERNETHY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 US 70 HWY UNIT 1039
Mailing Address - Street 2:
Mailing Address - City:SWANNANOA
Mailing Address - State:NC
Mailing Address - Zip Code:28778-0179
Mailing Address - Country:US
Mailing Address - Phone:828-491-0195
Mailing Address - Fax:
Practice Address - Street 1:2311 US 70 HWY UNIT 1039
Practice Address - Street 2:
Practice Address - City:SWANNANOA
Practice Address - State:NC
Practice Address - Zip Code:28778-0179
Practice Address - Country:US
Practice Address - Phone:828-491-0195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02940363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC0152FOtherMEDICARE PTAN
NC1144510926Medicaid
NCNC0152HOtherMEDICARE PTAN
1096871OtherNCCPA ID #
1096871OtherNCCPA ID #