1144547613 NPI number — CHRISTY L STRAND SLP

Table of content: CHRISTY L STRAND SLP (NPI 1144547613)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144547613 NPI number — CHRISTY L STRAND SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRAND
Provider First Name:
CHRISTY
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SLP
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:
1144547613
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/26/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 601529
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28260-1529
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-316-5500
Provider Business Mailing Address Fax Number:
704-316-2463

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10030 GILEAD RD
Provider Second Line Business Practice Location Address:
SUITE B100
Provider Business Practice Location Address City Name:
HUNTERSVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28078-7545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-316-5500
Provider Business Practice Location Address Fax Number:
704-316-2463
Provider Enumeration Date:
04/23/2010

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: 235Z00000X , with the licence number:  8269 , 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)