Provider Demographics
NPI:1588391825
Name:DOUTHIT, ERIN (AGNP-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:DOUTHIT
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 FETZNER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-2249
Mailing Address - Country:US
Mailing Address - Phone:585-472-0620
Mailing Address - Fax:
Practice Address - Street 1:12 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:CANASERAGA
Practice Address - State:NY
Practice Address - Zip Code:14822-9721
Practice Address - Country:US
Practice Address - Phone:607-545-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310759363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health