1437499597 NPI number — MRS. MILDRED SHARON LINDLEY MA

Table of content: MRS. MILDRED SHARON LINDLEY MA (NPI 1437499597)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437499597 NPI number — MRS. MILDRED SHARON LINDLEY MA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LINDLEY
Provider First Name:
MILDRED
Provider Middle Name:
SHARON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHASE
Provider Other First Name:
MILDRED
Provider Other Middle Name:
SHARON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437499597
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 528
Provider Second Line Business Mailing Address:
ATTN: BH EMERGENCY SERVICE
Provider Business Mailing Address City Name:
BETHEL
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99559-0528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-543-6100
Provider Business Mailing Address Fax Number:
904-543-6159

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CHIEF EDDIE HOFFMAN HIGHWAY, BUILDING SUITE #150
Provider Second Line Business Practice Location Address:
YKHC BH EMERGENCY SERVICE
Provider Business Practice Location Address City Name:
BETHEL
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99559-0528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-543-6100
Provider Business Practice Location Address Fax Number:
907-543-6159
Provider Enumeration Date:
02/26/2013

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: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1020986 , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".