Provider Demographics
NPI:1174992192
Name:DE LOS REYES, ERIN (NP-C, APRN)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:DE LOS REYES
Suffix:
Gender:F
Credentials:NP-C, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 HIGHWAY 34 E
Mailing Address - Street 2:SUITE A2
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2191
Mailing Address - Country:US
Mailing Address - Phone:770-251-2000
Mailing Address - Fax:
Practice Address - Street 1:1605 HIGHWAY 34 E
Practice Address - Street 2:SUITE A2
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2191
Practice Address - Country:US
Practice Address - Phone:770-251-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN200121363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily