Provider Demographics
NPI:1306217872
Name:FITZGERALD, ERIN SANFORD (FNP, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:SANFORD
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:FNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2792
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-2792
Mailing Address - Country:US
Mailing Address - Phone:971-465-9556
Mailing Address - Fax:888-224-4514
Practice Address - Street 1:820 SE HIGHWAY 101 STE E2
Practice Address - Street 2:
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-2773
Practice Address - Country:US
Practice Address - Phone:971-465-9556
Practice Address - Fax:888-224-4514
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201507586NP-PP363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily