Basic Information
| Provider Information | |||||||||
| NPI: | 1306101357 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZIELIN WURM | ||||||||
| FirstName: | ERICA | ||||||||
| MiddleName: | LOUISE | ||||||||
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| Credential: | PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9400 ZANE AVE N | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN PARK | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554431814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7637638800 | ||||||||
| FaxNumber: | 7633154669 | ||||||||
| Practice Location | |||||||||
| Address1: | 6363 FRANCE AVE S STE 200 | ||||||||
| Address2: | |||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554352140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9522309100 | ||||||||
| FaxNumber: | 9529222525 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2012 | ||||||||
| LastUpdateDate: | 09/14/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | R168437-3 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.