1225169030 NPI number — MS. SHEILA ANN SHAPIRO WHCNP

Table of content: MS. SHEILA ANN SHAPIRO WHCNP (NPI 1225169030)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225169030 NPI number — MS. SHEILA ANN SHAPIRO WHCNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHAPIRO
Provider First Name:
SHEILA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
WHCNP
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:
1225169030
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1035 1ST AVE WEST
Provider Second Line Business Mailing Address:
FLATHEAD COMMUNITY HEALTH CENTER
Provider Business Mailing Address City Name:
KALISPELL
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59901-5607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-751-8113
Provider Business Mailing Address Fax Number:
406-751-8151

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1035 1ST AVE WEST
Provider Second Line Business Practice Location Address:
FLATHEAD COMMUNITY HEALTH CENTER
Provider Business Practice Location Address City Name:
KALISPELL
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59901-5607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-751-8113
Provider Business Practice Location Address Fax Number:
406-751-8151
Provider Enumeration Date:
03/07/2007

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: 363LW0102X , with the licence number:  RN12999 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0435084 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 37013 . This is a "BCBS" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 94416024 . This is a "BCHP" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




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