Provider Demographics
NPI:1194518076
Name:ELO, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:ELO
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 1:2007 LAPPER AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-8116
Mailing Address - Country:US
Mailing Address - Phone:515-203-1297
Mailing Address - Fax:
Practice Address - Street 1:2007 LAPPER AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-8116
Practice Address - Country:US
Practice Address - Phone:515-203-1297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty