1306138409 NPI number — EURPAN LESHER RN

Table of content: EURPAN LESHER RN (NPI 1306138409)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306138409 NPI number — EURPAN LESHER RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LESHER
Provider First Name:
EURPAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN
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:
1306138409
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3768
Provider Second Line Business Mailing Address:
378 W. OLIVE AVENUE, SUITE A
Provider Business Mailing Address City Name:
MERCED
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95344-3768
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-725-7149
Provider Business Mailing Address Fax Number:
209-725-1603

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
378 W OLIVE AVE STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERCED
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95348-3182
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-205-1103
Provider Business Practice Location Address Fax Number:
209-723-2543
Provider Enumeration Date:
05/06/2011

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: 163WW0000X , with the licence number:  398170 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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