Provider Demographics
NPI:1235114406
Name:MONBERG, ERIN LEIGH (CNM)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:LEIGH
Last Name:MONBERG
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:LEIGH
Other - Last Name:PHARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:3 GLEN COVE DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4232
Mailing Address - Country:US
Mailing Address - Phone:207-921-8900
Mailing Address - Fax:207-921-5296
Practice Address - Street 1:3 GLEN COVE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4232
Practice Address - Country:US
Practice Address - Phone:207-921-8900
Practice Address - Fax:207-921-5296
Is Sole Proprietor?:No
Enumeration Date:2005-12-10
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNM142008367A00000X
TNAPN8313367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife