Provider Demographics
NPI:1942452479
Name:MORTENSEN, ERIN ELIZABETH (RN)
Entity type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:ELIZABETH
Last Name:MORTENSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HARDING PL
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3222
Mailing Address - Country:US
Mailing Address - Phone:631-697-3739
Mailing Address - Fax:
Practice Address - Street 1:8 HARDING PL
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3222
Practice Address - Country:US
Practice Address - Phone:631-697-3739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY544395163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health