1124258652 NPI number — MRS. SKYE TRINITY NORTON M.A.

Table of content: MRS. SKYE TRINITY NORTON M.A. (NPI 1124258652)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124258652 NPI number — MRS. SKYE TRINITY NORTON M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NORTON
Provider First Name:
SKYE
Provider Middle Name:
TRINITY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124258652
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 36219
Provider Second Line Business Mailing Address:
YUCCA LODGE
Provider Business Mailing Address City Name:
FORT BAYARD
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
88036-6219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
575-537-8824
Provider Business Mailing Address Fax Number:
575-537-3760

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
149 CAMINO DEL CIELO
Provider Second Line Business Practice Location Address:
YUCCA LODGE
Provider Business Practice Location Address City Name:
FORT BAYARD
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
575-537-8824
Provider Business Practice Location Address Fax Number:
575-537-3760
Provider Enumeration Date:
07/17/2009

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: 101YA0400X , with the licence number:  0107061 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YM0800X , with the licence number: 0123441 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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