1326044017 NPI number — PATRICIA MARIE FINLEY CRNA

Table of content: PATRICIA MARIE FINLEY CRNA (NPI 1326044017)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326044017 NPI number — PATRICIA MARIE FINLEY CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINLEY
Provider First Name:
PATRICIA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FINLEY
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSNA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1326044017
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4101 HARDESTY RIDGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAYLORSVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40071-8287
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-550-8565
Provider Business Mailing Address Fax Number:
888-371-5855

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4101 HARDESTY RIDGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAYLORSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40071-8287
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-550-8565
Provider Business Practice Location Address Fax Number:
888-371-5855
Provider Enumeration Date:
06/27/2005

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: 367500000X , with the licence number:  043191 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 74431917 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001841500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".