Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | R27820 | ND |
NPI | 1003838590 |
---|---|
Provider Name | Erin L Volden |
First Address | Detroit Lakes, MN 56501-3905 |
Second Address | Detroit Lakes, MN 56501-3905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 17/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q64355 | (02) |