Provider Demographics
NPI:1356210181
Name:NESSLAGE, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:NESSLAGE
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 1:16224 YELLOWEYED DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-5020
Mailing Address - Country:US
Mailing Address - Phone:757-672-0197
Mailing Address - Fax:
Practice Address - Street 1:13750 W COLONIAL DR STE 350-121
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4204
Practice Address - Country:US
Practice Address - Phone:407-285-7907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-31
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist