Provider Demographics
NPI:1144959800
Name:DOOLIN, ERIN LATRICE
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:LATRICE
Last Name:DOOLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4080 1ST AVE NE STE 102
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3160
Mailing Address - Country:US
Mailing Address - Phone:319-382-2545
Mailing Address - Fax:319-481-4023
Practice Address - Street 1:4080 1ST AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3160
Practice Address - Country:US
Practice Address - Phone:319-382-2545
Practice Address - Fax:319-481-4023
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAX000712697Medicaid