Provider Demographics
NPI:1316335870
Name:DEAN, ERIN RENAE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:RENAE
Last Name:DEAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:RENAE
Other - Last Name:BURDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1490 E WALNUT ST STE A
Mailing Address - Street 2:
Mailing Address - City:WATSEKA
Mailing Address - State:IL
Mailing Address - Zip Code:60970-1806
Mailing Address - Country:US
Mailing Address - Phone:815-432-7693
Mailing Address - Fax:815-936-7228
Practice Address - Street 1:1490 E WALNUT ST STE A
Practice Address - Street 2:
Practice Address - City:WATSEKA
Practice Address - State:IL
Practice Address - Zip Code:60970-1806
Practice Address - Country:US
Practice Address - Phone:815-432-7693
Practice Address - Fax:815-936-7228
Is Sole Proprietor?:No
Enumeration Date:2015-01-06
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.011571363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily