Provider Demographics
NPI:1124545231
Name:HAVERKAMP, ERIN NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:HAVERKAMP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:NICOLE
Other - Last Name:SAWYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-643-6400
Mailing Address - Fax:515-643-5816
Practice Address - Street 1:411 LAUREL ST STE 3250
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3026
Practice Address - Country:US
Practice Address - Phone:515-643-6400
Practice Address - Fax:515-643-5816
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA088752363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant