Provider Demographics
NPI:1114376944
Name:MACBETH, ERIN LAMONTAGNE (FNP)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:LAMONTAGNE
Last Name:MACBETH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 RANDOLPH RD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-2015
Mailing Address - Country:US
Mailing Address - Phone:518-281-6029
Mailing Address - Fax:
Practice Address - Street 1:1551 RANDOLPH RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2015
Practice Address - Country:US
Practice Address - Phone:518-281-6029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY701657-1163W00000X
NY33341554363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse