Provider Demographics
NPI:1053785527
Name:DEXTER, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:DEXTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32040803 SLEDD HALL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32612-3201
Mailing Address - Country:US
Mailing Address - Phone:352-348-0881
Mailing Address - Fax:
Practice Address - Street 1:32040803 SLEDD HALL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32612-3201
Practice Address - Country:US
Practice Address - Phone:352-348-0881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-21
Last Update Date:2015-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program