1013339951 NPI number — KRISTEN LINDEMAN SHIFFLETT OTR/L

Table of content: KRISTEN LINDEMAN SHIFFLETT OTR/L (NPI 1013339951)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013339951 NPI number — KRISTEN LINDEMAN SHIFFLETT OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHIFFLETT
Provider First Name:
KRISTEN
Provider Middle Name:
LINDEMAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OTR/L
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LINDEMAN
Provider Other First Name:
KRISTEN
Provider Other Middle Name:
STEINER
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTR/L
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1013339951
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 N. CAROLINE STREET
Provider Second Line Business Mailing Address:
JOHN HOPKINS WILMER LOW VISION SERVICE WILLMER 317
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21287
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-614-7962
Provider Business Mailing Address Fax Number:
410-614-1670

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 N. WOLFE STREET WILMER 317
Provider Second Line Business Practice Location Address:
JOHNS HOPKINS EYE INSTITUTE LOW VISION SERVICE
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21287
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-955-0580
Provider Business Practice Location Address Fax Number:
410-614-1670
Provider Enumeration Date:
01/13/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225XG0600X , with the licence number:  05900 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XL0004X , with the licence number: 05900 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XN1300X , with the licence number: 05900 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XP0019X , with the licence number: 05900 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)