Provider Demographics
NPI:1730765868
Name:EDMUNDS, ERIN RACHELLE (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:RACHELLE
Last Name:EDMUNDS
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:RACHELLE
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:495 SILVER MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-5906
Mailing Address - Country:US
Mailing Address - Phone:404-862-0297
Mailing Address - Fax:404-777-2042
Practice Address - Street 1:495 SILVER MEADOWS DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-5906
Practice Address - Country:US
Practice Address - Phone:404-862-0297
Practice Address - Fax:404-777-2042
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN258379363LA2100X
OR202108243NP-PP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care