1518282359 NPI number — MRS. JUDY NEUBRANDER FNP

Table of content: MRS. JUDY NEUBRANDER FNP (NPI 1518282359)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518282359 NPI number — MRS. JUDY NEUBRANDER FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEUBRANDER
Provider First Name:
JUDY
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MALLORY
Provider Other First Name:
JUDY
Provider Other Middle Name:
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:
1518282359
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
68 SWEETEN CREEK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28803-2318
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-274-2400
Provider Business Mailing Address Fax Number:
828-777-3389

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
68 SWEETEN CREEK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28803-2318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-274-2400
Provider Business Practice Location Address Fax Number:
828-777-3389
Provider Enumeration Date:
04/05/2010

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: 363LF0000X , with the licence number:  5004668 , 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)