Provider Demographics
NPI:1396934360
Name:SHANKS, ERIN E (RN)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:E
Last Name:SHANKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:E
Other - Last Name:HILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 FLETCHER PL
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-1812
Mailing Address - Country:US
Mailing Address - Phone:217-443-6402
Mailing Address - Fax:
Practice Address - Street 1:201 FLETCHER PL
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-1812
Practice Address - Country:US
Practice Address - Phone:217-443-6402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice