Provider Demographics
NPI:1447516059
Name:WILFONG, ERIN NICOLE (RN)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:NICOLE
Last Name:WILFONG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:NICOLE
Other - Last Name:MCLEOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:633 N WEST ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-1967
Mailing Address - Country:US
Mailing Address - Phone:717-275-2803
Mailing Address - Fax:
Practice Address - Street 1:361 ALEXANDER SPRING RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-6940
Practice Address - Country:US
Practice Address - Phone:717-960-1693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN620625163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine