1023044088 NPI number — MS. CATHERINE TAMBRONI-PARKER CNM

Table of content: MS. CATHERINE TAMBRONI-PARKER CNM (NPI 1023044088)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023044088 NPI number — MS. CATHERINE TAMBRONI-PARKER CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TAMBRONI-PARKER
Provider First Name:
CATHERINE
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TAMBRONI
Provider Other First Name:
CATHERINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CNM
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1023044088
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/18/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
989 RIBAUT ROAD, SUITE 210
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEAUFORT
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29902-5481
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-522-7870
Provider Business Mailing Address Fax Number:
843-522-7821

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 HOSPITAL DR
Provider Second Line Business Practice Location Address:
SUITE 4A
Provider Business Practice Location Address City Name:
HENDERSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28792-5248
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-650-8077
Provider Business Practice Location Address Fax Number:
828-651-0194
Provider Enumeration Date:
06/23/2006

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: 367A00000X , with the licence number:  000766 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: 530 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 184M1 . This is a "BCBS OF NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: P01308048 . This is a "MEDICARE RR" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 01870915 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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